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General NPI Number Information
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NPI Number | 1871597781
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Entity Type | Individual
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Provider Name | ROBERT BOND NOLAN JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 4119 BROWNS LN STE 1
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City | LOUISVILLE
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State | KY
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Zip | 40220-1500
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Country | US
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Telephone | 502-451-9296
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Fax | 502-451-9291
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Provider Business Mailing Address
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Address Line | 4119 BROWNS LN STE 1
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City | LOUISVILLE
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State | KY
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Zip | 40220-1500
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Country | US
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Telephone | 502-451-9296
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Fax | 502-451-9291
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23114
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License Number State | KY
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