Individual
DR. INDIRA S THIRKANNAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
234 E GRAY ST STE 766, LOUISVILLE, KY 40202-1901
(502) 583-7337
(502) 584-5437
Mailing address
234 E GRAY ST STE 766, LOUISVILLE, KY 40202-1901
(502) 583-7337
(502) 584-5437
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
25MA10411200
NJ
2086S0120X
Pediatric Surgery Physician
40425
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40425
STATE LICENSE
KY
Enumeration date
10/12/2006
Last updated
12/11/2024
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