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Contact Information

T. GERALD O'DANIEL M.D., PLLC
222 S 1ST ST
SUITE 100
LOUISVILLE, KY40202-1350
 Phone: 502-584-1109
 Fax: 502-589-6882
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

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

NPI Number 1457498107
LBN Legal business name T. GERALD O'DANIEL M.D., PLLC
Authorized official T. O'DANIEL - (SOLE PROPRIETOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2007
Last updated 10/28/2010 - About 16 years ago
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 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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