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General NPI Number Information
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NPI Number | 1629273040
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Entity Type | Organization
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Legal Business Name | H. MICHAEL KHOURY, MD,LLC
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Dates
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Enumeration Date | 06/16/2007
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 107 MANOR AVE STE 205
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City | BARDSTOWN
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State | KY
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Zip | 40004-2800
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Country | US
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Telephone | 502-349-6641
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Fax | 502-349-6642
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Provider Business Mailing Address
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Address Line | PO BOX 43534
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City | LOUISVILLE
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State | KY
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Zip | 40253-0534
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Country | US
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Telephone | 502-349-6641
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Fax | 502-349-6642
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HABIB MICHAEL KHOURY
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Credential | M.D
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Telephone | 502-349-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34774
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License Number State | KY
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