Short, Kerry Lynn

Short, Kerry Lynn is an individual health care provider with primary practice located at 4001 Kresge Way , Louisville KY 40207-4640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Urology, which is considered as his primary health care specialty. Short, Kerry Lynn can be contacted via phone (502) 897-7416.

Contact Information

Primary practice address
4001 Kresge Way Louisville KY 40207-4640
Fax: (502) 895-6638
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X 20965 Kentucky

Profile Details

NPI number 1902879901
LBN Legal business name Short, Kerry Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Apr 12th, 2021 - about 5 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 1902879901 NPPES
Kentucky MEDICAID 64209653

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