MEDICARE: PETER JOHN GIANNONE JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	46822	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124020144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER JOHN GIANNONE JR. MD

Provider Business Mailing Address
First Line	:	800 ROSE STREET MN 470
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-323-1496
Fax Number	:	859-257-6066

Provider Business Practice Location Address
First Line	:	800 ROSE STREET MN 470
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-323-1496
Fax Number	:	859-323-1496

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/07/2015

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