T. GERALD O'DANIEL M.D. PLLC NPI 1457498107

NPI Information

NPI: 1457498107
Provider Name: T. GERALD O'DANIEL M.D., PLLC
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
222 S 1ST ST
SUITE 100
LOUISVILLE, KY
ZIP 40202
Phone: (502) 584-1109
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T. GERALD O'DANIEL M.D., PLLC is a plastic and reconstructive surgery surgery in Louisville, KY. The provider is a surgeon who specializes in plastic and reconstructive surgery. T. GERALD O'DANIEL M.D., PLLC NPI is 1457498107. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

222 S 1ST ST
SUITE 100
LOUISVILLE, KY
ZIP 40202-350
Phone: (502) 584-1109
Fax: (502) 589-6882

The provider's authorized official is T. Gerald O'daniel .
The authorized official title is Sole Proprietor and has the following contact phone number (502) 584-1109.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 10/28/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	24070	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1918001	MEDICARE PIN	KENTUCKY
2	1058697	OTHER	KENTUCKY	PASSPORT PIN
3	KY1118	OTHER	KENTUCKY	HEALTHNET
4	C72177	MEDICARE UPIN	KENTUCKY
5	000000219660	OTHER	KENTUCKY	ANTHEM PIN
6	100033340A	MEDICAID	INDIANA
7	002	OTHER	KENTUCKY	CIGNA
8	667357	OTHER	KENTUCKY	HEALTHLINK
9	KY0057799	OTHER	KENTUCKY	TRICARE
10	240007956	MEDICARE ID-TYPE UNSPECIFIED	KENTUCKY	RAILROAD MEDICARE ID
11	64240708	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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