Provider Demographics
NPI:1225303977
Name:GEORGE KUDMANI PSC
Entity Type:Organization
Organization Name:GEORGE KUDMANI PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUDMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-933-0623
Mailing Address - Street 1:9702 STONESTREET RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-6819
Mailing Address - Country:US
Mailing Address - Phone:502-933-0623
Mailing Address - Fax:502-995-2428
Practice Address - Street 1:9702 STONESTREET RD
Practice Address - Street 2:SUITE 306
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-6819
Practice Address - Country:US
Practice Address - Phone:502-933-0623
Practice Address - Fax:502-995-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21041207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty