Provider Demographics
NPI:1710259353
Name:GOLDMAN, BART JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:BART
Middle Name:JOHN
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 S HURSTBOURNE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5757
Mailing Address - Country:US
Mailing Address - Phone:502-327-9958
Mailing Address - Fax:
Practice Address - Street 1:1230 S HURSTBOURNE PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5757
Practice Address - Country:US
Practice Address - Phone:502-327-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24683207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery