Pridham, Dwight

Pridham, Dwight is an individual health care provider with primary practice located at 4123 Dutchmans Ln Suite 300, Louisville KY 40207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Pridham, Dwight can be contacted via phone (502) 899-6755.

Contact Information

Primary practice address
4123 Dutchmans Ln Suite 300 Louisville KY 40207
Phone: (502) 899-6755
Fax: (502) 899-6753
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 25165 Kentucky

Profile Details

NPI number 1558369546
LBN Legal business name Pridham, Dwight
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Dec 21st, 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 1558369546 NPPES
Kentucky Other K024740 MEDICARE PTAN- WOMEN'S SPECIALISTS
Kentucky MEDICAID 64251655 MEDICARE PTAN- WOMEN'S SPECIALISTS

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