Basic Information
| Provider Information | |||||||||
| NPI: | 1245454545 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMMONS | ||||||||
| FirstName: | KARA | ||||||||
| MiddleName: | BROOK | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 950293 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402950293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056823303 | ||||||||
| FaxNumber: | 4057928993 | ||||||||
| Practice Location | |||||||||
| Address1: | 4171 WESTPORT RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402072739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028968868 | ||||||||
| FaxNumber: | 5028958794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 03/28/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 43499 | KY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.