Individual
JOHN MICHAEL GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 KRESGE WAY, SUITE 51-A, LOUISVILLE, KY 40207-4660
(502) 891-8981
(502) 891-4548
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 272-5100
(502) 272-5114
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35530
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210852
ANTHEM PROVIDER #
KY
01
—
000000694535
ANTHEM-NRP
KY
01
—
000057080Z
HUMANA-NRP
KY
01
—
009597
SIHO-NRP
KY
01
—
1152901
PASSPORT
KY
05
—
200253020
—
IN
01
—
2438719000
PASSPORT ADVANTAGE
KY
01
—
400040047
MEDICARE PTAN -- NRP
KY
01
—
4881531
CIGNA-NRP
KY
01
—
50031805
PASSPORT HEALTH -NRP
KY
05
—
64002199
—
KY
01
—
M400053460
MEDICARE PTAN- NORTON REHAB. PHYSICIANS
IN
Enumeration date
02/14/2006
Last updated
03/08/2012
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