Individual
DR. GARY GOLDBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 LYNDON LN, SUITE B, LOUISVILLE, KY 40222-5550
(502) 896-0707
Mailing address
PO BOX 5338, LOUISVILLE, KY 40255-0338
(502) 896-0707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24422
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6424422100
—
KY
Enumeration date
01/13/2007
Last updated
06/10/2008
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