Individual
VICTORIA MERCADO BAULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
596 WESTPORT RD, SUITE NO 101, ELIZABETHTOWN, KY 42701
(270) 769-6888
(270) 769-9199
Mailing address
596 WESTPORT RD, SUITE NO 101, ELIZABETHTOWN, KY 42701
(270) 769-6888
(270) 769-9199
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32555
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1075484
PASSPORT
KY
05
—
64325558
—
KY
Enumeration date
11/13/2006
Last updated
07/09/2007
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