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Individual

STEPHEN H CHURCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4171 WESTPORT RD, LOUISVILLE, KY 40207-2739
(502) 896-8868
(502) 895-6278
Mailing address
4171 WESTPORT RD, LOUISVILLE, KY 40207-2739
(502) 896-8868
(502) 895-6278

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19565
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64195654
KY
Enumeration date
07/21/2006
Last updated
12/19/2016
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