Gleason, John Russell

Gleason, John Russell is an individual health care provider with primary practice located at 6400 Dutchmans Pkwy Ste 250, Louisville KY 40205-3340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Gleason, John Russell can be contacted via phone (502) 587-9660.

Contact Information

Primary practice address
6400 Dutchmans Pkwy Ste 250 Louisville KY 40205-3340
Phone: (502) 587-9660
Fax: (502) 540-5615
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 25233 Kentucky

Profile Details

NPI number 1215931159
LBN Legal business name Gleason, John Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Aug 29th, 2007 - about 17 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 1215931159 NPPES
Kentucky Other 1050705 PASSPORT
Kentucky Other 000000062784 PASSPORT
Kentucky MEDICAID 64252331 PASSPORT

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