Individual
DOUGLAS J DELAFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 DUTCHMANS PKWY, SUITE 300, LOUISVILLE, KY 40205-3340
(502) 894-2444
(502) 894-2445
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01039459
IN
207Q00000X
Family Medicine Physician
Primary
28936
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520323
ANTHEM
KY
01
—
005717
SIHO
KY
05
—
100194360
—
IN
01
—
3436186000
PASSPORT ADVANTAGE
KY
01
—
50017532
PASSPORT
KY
05
—
7100026500
—
KY
01
—
P00415237
RAILROAD MEDICARE
KY
Enumeration date
06/11/2006
Last updated
08/31/2016
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