Provider Demographics
NPI:1871597740
Name:NEHIL, JOHN LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LAWRENCE
Last Name:NEHIL
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 1:3 AUDUBON PLAZA DR
Mailing Address - Street 2:STE 640
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1362
Mailing Address - Country:US
Mailing Address - Phone:502-636-9118
Mailing Address - Fax:502-636-9103
Practice Address - Street 1:3 AUDUBON PLAZA DR
Practice Address - Street 2:STE 640
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1362
Practice Address - Country:US
Practice Address - Phone:502-636-9118
Practice Address - Fax:502-636-9103
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20600207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047213OtherANTHEM PROVIDER #
KY64206006Medicaid
KY64206006Medicaid
KY1295401Medicare PIN