Healthcare Provider Details

I. General information

NPI: 1891794889
Provider Name (Legal Business Name): ALAN A FERRARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 644 SUITE 203
LOUISA KY
41230
US

IV. Provider business mailing address

PO BOX 30
LOUISA KY
41230-0030
US

V. Phone/Fax

Practice location:
  • Phone: 606-638-4888
  • Fax: 606-638-9003
Mailing address:
  • Phone: 606-638-4888
  • Fax: 606-638-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number32454
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: