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Individual

JUDITH ANN THERIOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
411 E CHESTNUT ST # STREET1, LOUISVILLE, KY 40202-1713
(502) 588-3440
(502) 588-3441
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31361
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6431361200
KY
Enumeration date
05/27/2005
Last updated
10/27/2020
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