Provider Demographics
NPI:1164840385
Name:GORSKI, JUSTIN WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:WAYNE
Last Name:GORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:502-272-5052
Mailing Address - Fax:502-629-6217
Practice Address - Street 1:3991 DUTCHMANS LN STE 405
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4723
Practice Address - Country:US
Practice Address - Phone:502-899-3366
Practice Address - Fax:502-899-6686
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY51094207V00000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology