Individual
NICHOLAS PER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1023 NEW MOODY LN STE 103, LA GRANGE, KY 40031-9179
(502) 222-5558
(502) 222-3040
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
59716
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2020
Last updated
06/21/2024
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