Individual
GORDEN THOMAS MCMURRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4004 DUPONT CIR, SUITE 220, LOUISVILLE, KY 40207-4819
(502) 893-0159
(502) 213-3853
Mailing address
PO BOX 950116, SUITE 220, LOUISVILLE, KY 40295-0116
(502) 893-0159
(502) 213-3853
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
14174
KY
207Y00000X
Otolaryngology Physician
01039324A
IN
207Y00000X
Otolaryngology Physician
Primary
14174
KY
207YX0901X
Otology & Neurotology Physician
14174
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040003867
MEDICARE RR
KY
05
—
64141740
—
KY
Enumeration date
06/28/2005
Last updated
04/17/2017
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