National Provider Identifier Database

T GERALD ODANIEL MD PLLC
Plastic and Reconstructive Surgery

Contact Information

T. GERALD O'DANIEL M.D., PLLC
222 S 1ST ST
SUITE 100
LOUISVILLE, KY  40202-1350
Phone: 502-584-1109
Fax: 502-589-6882
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for T. GERALD O'DANIEL M.D., PLLC

NPI Number 1457498107
Legal business name
LBN		 T. GERALD O'DANIEL M.D., PLLC
Authorized official T. O'DANIEL - (SOLE PROPRIETOR)
Entity Organization
Organization subpart No
Enumeration date 01/31/2007
Last updated 10/28/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • KY License #: 24070
  • IN Medicaid: 100033340A
  • KY Medicaid: 64240708
  • KY Other: 000000219660 ANTHEM PIN
  • KY Other: 002 CIGNA
  • KY Other: 667357 HEALTHLINK
  • KY Other: KY1118 HEALTHNET
  • KY Other: 1058697 PASSPORT PIN
  • KY Other: KY0057799 TRICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for T. GERALD O'DANIEL M.D., PLLC

There are currently no reviews for T. GERALD O'DANIEL M.D., PLLC

NPIdb - Home
v2.201