Provider Demographics
NPI:1043344120
Name:NOH, JAMES Y (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:Y
Last Name:NOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YEO
Other - Middle Name:JUH
Other - Last Name:NOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11102 PERWINKLE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-4105
Mailing Address - Country:US
Mailing Address - Phone:502-231-3138
Mailing Address - Fax:
Practice Address - Street 1:11102 PERWINKLE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4105
Practice Address - Country:US
Practice Address - Phone:502-231-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17523174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64175235Medicaid
KY1366601Medicare ID - Type Unspecified
KYD34187Medicare UPIN