Individual
GERARD V SICILIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3999 DUTCHMANS LN, SUITE 7B, LOUISVILLE, KY 40207-4729
(502) 896-4711
(502) 896-4791
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
32151
KY
207RG0100X
Gastroenterology Physician
Primary
32151
KY
208600000X
Surgery Physician
32151
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049918
ANTHEM PIN #
KY
05
—
201080170
—
IN
01
—
50034545
PASSPORT- NORTON SURGICAL SPECIALISTS
KY
05
—
64321516
—
KY
Enumeration date
03/28/2006
Last updated
01/21/2021
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