Provider Demographics
NPI:1184709594
Name:RADNOTHY, LOUIS MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:MICHAEL
Last Name:RADNOTHY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 3147
Mailing Address - Street 2:YUMA PROVING GROUNDS
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-0903
Mailing Address - Country:US
Mailing Address - Phone:928-920-0782
Mailing Address - Fax:928-328-3635
Practice Address - Street 1:5210 N 19TH AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2946
Practice Address - Country:US
Practice Address - Phone:928-920-0782
Practice Address - Fax:928-328-3635
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-09-25
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Provider Licenses
StateLicense IDTaxonomies
AZ4480207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine