Healthcare Provider Details

I. General information

NPI: 1174128581
Provider Name (Legal Business Name): PAUL HOHMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHESTNUT ST
LOUISVILLE KY
40202-1831
US

IV. Provider business mailing address

1014 EVERETT AVE
LOUISVILLE KY
40204-1216
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-8000
  • Fax:
Mailing address:
  • Phone: 502-500-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1132264
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1132264
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: