Individual
DEANNA RAE TODD TZANETOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-6000
(502) 629-5865
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39283
KY
208000000X
Pediatrics Physician
39283
KY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
39283
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6412376300
—
KY
Enumeration date
10/04/2006
Last updated
10/29/2020
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