Organization
KERRY L SHORT, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY LYNN SHORY M.D. (OWNER)
(502) 897-7416
Entity
Organization
Contact information
Practice address
4001 KRESGE WAY STE 315, LOUISVILLE, KY 40207-4640
(502) 897-7416
(502) 895-6638
Mailing address
4001 KRESGE WAY STE 315, LOUISVILLE, KY 40207-4640
(502) 897-7416
(502) 895-6638
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20965
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64209653
—
KY
Enumeration date
12/21/2007
Last updated
12/21/2007
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