Individual
DR. FABIAN CARBALLO MADRIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 ABRAHAM FLEXNER WAY STE 1200, LOUISVILLE, KY 40202-3826
(502) 588-2160
(502) 588-2161
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0325
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
45220
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
45220
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
TP426
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201109750
—
IN
05
—
7100226970
—
KY
01
—
775158
ANTHEM- NLSC
KY
01
—
K052580
MEDICARE- NORTON LEATHERMAN SPINE
KY
Enumeration date
06/20/2012
Last updated
03/30/2021
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