Provider Demographics
NPI:1326133307
Name:NOBILE, GEORGE OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:OSCAR
Last Name:NOBILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8703 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1378
Mailing Address - Country:US
Mailing Address - Phone:502-523-1617
Mailing Address - Fax:
Practice Address - Street 1:3205 SUMMIT SQUARE PL
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2650
Practice Address - Country:US
Practice Address - Phone:859-335-9041
Practice Address - Fax:859-335-9072
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28211207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64282114Medicaid