Individual
DR. CHRISTOPHER E NOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MD
Contact information
Practice address
225 ABRAHAM FLEXNER WAY, STE 302, LOUISVILLE, KY 40202-1882
(502) 587-7874
(502) 587-0758
Mailing address
2800 CANNONS LN, STE 100, LOUISVILLE, KY 40205
(502) 454-4885
(502) 452-1926
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7486
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
MD-39508
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364871
BCBS
KY
05
—
200521540
—
IN
05
—
60003274
—
KY
05
—
64098635
—
KY
Enumeration date
08/23/2005
Last updated
06/12/2017
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