Individual
DR. JOHN T MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1741 MIDLAND TRL, SHELBYVILLE, KY 40065-1711
(502) 633-0192
(502) 633-0192
Mailing address
18 VILLAGE PLZ, PMB 136, SHELBYVILLE, KY 40065
(502) 633-0192
(502) 633-4164
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
28822
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200143910A/B
—
IN
01
—
50040687
PASSPORT (JPG)
KY
05
—
64288228
—
KY
Enumeration date
11/11/2005
Last updated
10/07/2020
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