Individual
JERRY WALTER SELIGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5811 GLEN PARK RD, LOUISVILLE, KY 40222-5980
(502) 425-2242
Mailing address
5811 GLEN PARK RD, LOUISVILLE, KY 40222-5980
(502) 425-2364
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13947
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64139470
—
KY
Enumeration date
05/09/2007
Last updated
07/08/2007
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