Individual
MARTIN S VYLETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 S JACKSON ST, SUITE C07, LOUISVILLE, KY 40202-1675
(502) 852-5875
(502) 852-1754
Mailing address
530 S JACKSON ST, SUITE C07, LOUISVILLE, KY 40202-1675
(502) 852-5875
(502) 852-1754
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
FL029
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100084730
—
KY
Enumeration date
08/07/2009
Last updated
07/13/2021
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