Healthcare Provider Details

I. General information

NPI: 1467441915
Provider Name (Legal Business Name): LARRY L ZHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 S HURSTBOURNE PKWY UNIT 120
LOUISVILLE KY
40222-5757
US

IV. Provider business mailing address

1230 S HURSTBOURNE PKWY STE 120
LOUISVILLE KY
40222-5757
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-3225
  • Fax: 502-425-3225
Mailing address:
  • Phone: 502-425-3225
  • Fax: 502-425-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35943
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: