Anciano Granadillo, Victor Jose

Anciano Granadillo, Victor Jose is an individual health care provider with primary practice located at 4402 Churchman Ave Ste 300 , Louisville KY 40215-3101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Anciano Granadillo, Victor Jose can be contacted via phone (502) 363-0588.

Contact Information

Primary practice address
4402 Churchman Ave Ste 300 Louisville KY 40215-3101
Phone: (502) 363-0588
Fax: (502) 363-0972
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 55434 Kentucky

Profile Details

NPI number 1841686995
LBN Legal business name Anciano Granadillo, Victor Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2015
Last updated Aug 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841686995 NPPES
North Carolina Other 0397730024 NSC#
North Carolina MEDICAID 300053739 NSC#
North Carolina MEDICAID 7100757450 NSC#

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