Individual
MARK WILLIAM SANSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 361-6617
(502) 361-6637
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
49621
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300032455
—
IN
05
—
7100612740
—
KY
Enumeration date
03/31/2014
Last updated
06/14/2022
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