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General NPI Number Information
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NPI Number | 1073133054
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Entity Type | Organization
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Legal Business Name | JOSEPH LARATTA MD SPINE SURGEON, LLC
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 1169 EASTERN PKWY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40217-1412
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Country | US
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Telephone | 502-413-5777
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Fax | 502-413-5766
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Provider Business Mailing Address
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Address Line | 743 E BROADWAY # 171
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City | LOUISVILLE
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State | KY
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Zip | 40202-1711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH L LARATTA
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Credential | MD
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Telephone | 973-979-1370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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