Individual
KATHRYN MCCARTHY MULLOOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4123 DUTCHMANS LN STE 101, LOUISVILLE, KY 40207-4718
(502) 584-7525
(502) 584-6851
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125051492
IL
207XS0117X
Orthopaedic Surgery of the Spine Physician
44341
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
E-7445
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193592001
—
AR
01
—
201029870
MEDICAID- NORTON LEATHERMAN SPINE
IN
01
—
7100167920
MEDICAID- NORTON LEATHERMAN SPINE
KY
01
—
E-7445
AR MEDICAL LICENSE
AR
01
—
K030600
MEDICARE PTAN -- NORTON LEATHERMAN SPINE
KY
Enumeration date
07/30/2008
Last updated
09/06/2024
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