Individual
DR. SURAJ K GATHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12010 SHELBYVILLE RD, SUITE 500, LOUISVILLE, KY 40243-1054
(502) 238-2800
(502) 238-2805
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48219
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
TAXONOMY
KY
Enumeration date
03/22/2012
Last updated
12/02/2020
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