1861495046 NPI number — DR. GEORGE B SONNIER M.D.

Table of content: DR. GEORGE B SONNIER M.D. (NPI 1861495046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861495046 NPI number — DR. GEORGE B SONNIER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SONNIER
Provider First Name:
GEORGE
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861495046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 E BROADWAY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-585-5249
Provider Business Mailing Address Fax Number:
502-585-5251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 E BROADWAY
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-585-5249
Provider Business Practice Location Address Fax Number:
502-585-5251
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZD0900X , with the licence number:  32539 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: 32539 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: 32539 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000247638 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 480193 . This is a "HEALTHLINK" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 096605 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 690009345 . This is a "MEDICARE RR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50115684 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01896394 . This is a "ANTHEM MA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 300047661100 . This is a "HUMANA CARESOURCE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 601519 . This is a "WELLCARE MA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 03-00228 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200091750A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4046475 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64984495 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 114358 . This is a "AETNA BETTER HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3103050 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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