Provider Demographics
NPI:1861495046
Name:SONNIER, GEORGE B (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:B
Last Name:SONNIER
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 1:310 E BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1745
Mailing Address - Country:US
Mailing Address - Phone:502-585-5249
Mailing Address - Fax:502-585-5251
Practice Address - Street 1:310 E BROADWAY
Practice Address - Street 2:STE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1745
Practice Address - Country:US
Practice Address - Phone:502-585-5249
Practice Address - Fax:502-585-5251
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32539207ZD0900X, 207ZP0102X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000247638OtherANTHEM
KY480193OtherHEALTHLINK
KY096605OtherHEALTH ALLIANCE
KY690009345OtherMEDICARE RR
KY50115684OtherPASSPORT
KY01896394OtherANTHEM MA
KY300047661100OtherHUMANA CARESOURCE
KY601519OtherWELLCARE MA
KY03-00228OtherUNITED HEALTHCARE
IN200091750AMedicaid
TN4046475Medicaid
KY64984495Medicaid
KY114358OtherAETNA BETTER HEALTH
NH3103050Medicaid
IN200091750AMedicaid
TN4046475Medicaid