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Mr. Thaddeus Beam Riley, PA
Medical Physician Assistant in Louisville, Kentucky
NPI 1144417999

Thaddeus Beam Riley is a Medical Physician Assistant based in Louisville, KY and is specialized in Medical. Thaddeus Beam Riley practices in Louisville, KY and has the professional credentials of PA. The NPI Number for Thaddeus Beam Riley is 1144417999 and holds a License No. PA1070 (Kentucky).

The current practice location address for Thaddeus Beam Riley is 947 Eastern Pkwy, Louisville, KY and can be reached out via phone at 502-361-8801 and via fax at 502-361-8821.

Location: 947 Eastern Pkwy, Louisville, KY, 40217-1573
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Provider Profile Details
NPI Number
1144417999
Provider Name
Thaddeus Beam Riley
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
947 Eastern Pkwy, Louisville, KY, 40217-1573
Phone Number
502-361-8801
Fax Number
502-361-8821
Provider Enumeration Date
09/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1144417999 01 KY NPI
institution
Provider Business Practice Location Address Details
Address
947 Eastern Pkwy
City
State
Zip
40217-1573
Phone Number
502-361-8801
Fax Number
502-361-8821
person
Provider Business Mailing Address Details
Address
947 Eastern Pkwy
City
State
Zip
40217-1573
Phone Number
502-361-8801
Fax Number
502-361-8821
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA1070 (Kentucky)
Definition
Definition to come...
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