Individual
DR. NICHOLAS CHARLES MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ZORN AVE, GEC DIVISION, LOUISVILLE, KY 40206-1433
(502) 287-4000
Mailing address
800 ZORN AVE, GEC DIVISION, LOUISVILLE, KY 40206-1433
(502) 287-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42491
KY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
42491
KY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
42491
KY
Other
Enumeration date
02/23/2007
Last updated
03/04/2013
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