MEDICARE: DR. GEORGE B SONNIER M.D.

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	207ZD0900X	Dermatopathology (Pathology) Physician	32539	KY
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	32539	KY
3	207N00000X	Dermatology Physician	32539	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	690009345	OTHER	KY	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000247638	OTHER	KY	ANTHEM
2	480193	OTHER	KY	HEALTHLINK
3	096605	OTHER	KY	HEALTH ALLIANCE
5	50115684	OTHER	KY	PASSPORT
6	01896394	OTHER	KY	ANTHEM MA
7	300047661100	OTHER	KY	HUMANA CARESOURCE
8	601519	OTHER	KY	WELLCARE MA
9	03-00228	OTHER	KY	UNITED HEALTHCARE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	114358	OTHER	KY	AETNA BETTER HEALTH
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861495046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE B SONNIER M.D.

Provider Business Mailing Address
First Line	:	310 E BROADWAY STE 200
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1745
Country	:	US
Telephone Number	:	502-585-5249
Fax Number	:	502-585-5251

Provider Business Practice Location Address
First Line	:	310 E BROADWAY
Second Line	:	STE 200
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1745
Country	:	US
Telephone Number	:	502-585-5249
Fax Number	:	502-585-5251

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/19/2021

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