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Individual

DR. JOSEPH J CREELY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4950 NORTON HEALTHCARE BLVD, SUITE 209, LOUISVILLE, KY 40241-2831
(502) 425-5556
(502) 425-5655
Mailing address
4950 NORTON HEALTHCARE BLVD, SUITE 209, LOUISVILLE, KY 40241-2831
(502) 425-5556
(502) 425-5655

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
088562
LA
207Y00000X
Otolaryngology Physician
Primary
32074
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000571067
BCBS
KY
01
20-4612802
TAX ID
KY
05
64320740
KY
Enumeration date
06/21/2005
Last updated
11/21/2024
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