Individual
GEORGE J MIKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 AUDUBON PLAZA DR STE 560, LOUISVILLE, KY 40217-1376
(502) 636-8004
(502) 636-8384
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35282
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000495881
ANTHEM - CTS
—
01
—
078880
SIHO - CTS
—
05
—
200276930
—
IN
01
—
2757822000
PAD - CTS 3APD
—
01
—
2757831000
PAD - CTS 234 EGS
—
01
—
50011793
PASSPORT - CTS 234EGS
—
01
—
50011794
PASSPORT - CTS 3APD
—
05
—
64004187
—
KY
01
—
P00374287
RRMCR - CTS
KY
Enumeration date
03/28/2006
Last updated
01/20/2021
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