Provider Demographics
NPI:1568094720
Name:YOSHIDA, KEI
Entity Type:Individual
Prefix:MR
First Name:KEI
Middle Name:
Last Name:YOSHIDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 LIBRARY LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2170
Mailing Address - Country:US
Mailing Address - Phone:502-249-4791
Mailing Address - Fax:
Practice Address - Street 1:901 S 2ND ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2399
Practice Address - Country:US
Practice Address - Phone:502-249-4791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
T148036016OtherTOKYO MARINE NICHIDO