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General NPI Number Information
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NPI Number | 1174562508
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Entity Type | Individual
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Provider Name | VESNA MARTICH KRISS MD
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 231 E CHESTNUT ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1821
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Country | US
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Telephone | 502-629-7661
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Fax | 502-629-5309
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-272-5134
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Fax | 502-272-5339
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 29532
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 29532
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License Number State | KY
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