Individual
DR. COLE S CONDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MSC
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 629-5991
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 629-6000
(502) 629-5991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04-32974
KS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
04-32974
KS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
38540
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200481480
—
IN
05
—
200563930A
—
KS
05
—
64080484
—
KY
Enumeration date
12/02/2005
Last updated
10/27/2015
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