Individual
DR. RONALD J. ELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
530 S JACKSON ST, DEPARTMENT OF PATHOLOGY & LAB MEDICINE, LOUISVILLE, KY 40202-1675
(502) 852-4464
(502) 852-1761
Mailing address
PO BOX 22214, LOUISVILLE, KY 40252-0214
(502) 852-1648
(502) 852-2046
Taxonomy
Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
33254
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
33254
KY
207ZP0104X
Chemical Pathology Physician
Primary
33254
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1050558
PASSPORT-KY MED MG CARE
KY
05
—
200212190
—
IN
01
—
64-332547
MEDICAID
KY
Enumeration date
12/22/2005
Last updated
09/11/2012
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