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NPI 1497379846

NPI 1497379846 : LEE ARYN MYERS-WHITE PA-C : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1497379846
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    Entity Type          |    Individual 
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    Provider Name        |    LEE ARYN MYERS-WHITE PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/02/2020
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    Last Update Date     |    04/12/2024
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Provider Practice Location Address
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    Address Line         |    201 ABRAHAM FLEXNER WAY STE 1200 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40202-3841
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    Country              |    US
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    Telephone            |    502-588-7600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 909 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40201-0909
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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    |    
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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        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA9118472
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    License Number State |    FL
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