Desjardins, Matthew Todd

Desjardins, Matthew Todd is an individual health care provider with primary practice located at 560 S Loop Rd , Edgewood KY 41017-3405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Desjardins, Matthew Todd can be contacted via phone (859) 301-2663.

Contact Information

Primary practice address
560 S Loop Rd Edgewood KY 41017-3405
Phone: (859) 301-2663
Fax: (859) 301-0655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 38980 Kentucky

Profile Details

NPI number 1699777847
LBN Legal business name Desjardins, Matthew Todd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated May 11th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699777847 NPPES
Kentucky Other 90008962 MEDICAID DME
Kentucky MEDICAID 64088594 MEDICAID DME
Kentucky Other CB8861 MEDICAID DME
Kentucky Other P00156471 MEDICAID DME
Kentucky Other 000000333833 MEDICAID DME
Kentucky Other 0428850004 MEDICAID DME

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