Short, Ethan

Short, Ethan is an sole proprietor health care provider with primary practice located at 228 Delmont Ave , Louisville KY 40206-1025. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Short, Ethan can be contacted via phone (502) 619-0636.

Contact Information

Primary practice address
228 Delmont Ave Louisville KY 40206-1025
Phone: (502) 619-0636
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01091358A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X R4865 Kentucky
Allopathic & Osteopathic Physicians / General Practice 208D00000X 54489 Kentucky
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 54489 Kentucky

Profile Details

NPI number 1629502604
LBN Legal business name Short, Ethan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 17th, 2017
Last updated Aug 22nd, 2023 - about 2 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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