Provider Demographics
NPI:1467441915
Name:ZHOU, LARRY L (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:L
Last Name:ZHOU
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 STE 120
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5757
Mailing Address - Country:US
Mailing Address - Phone:502-425-3225
Mailing Address - Fax:502-425-3225
Practice Address - Street 1:1230 S HURSTBOURNE PKWY
Practice Address - Street 2:UNIT 120
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5757
Practice Address - Country:US
Practice Address - Phone:502-425-3225
Practice Address - Fax:502-425-3225
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35943208VP0014X
IN01047838207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200283260Medicaid
KY64016124Medicaid
IN2687Medicare PIN
IN200283260Medicaid
CA4891Medicare PIN
CA4891Medicare PIN