Samuel Paul Bockhorst, MD Medical Student
Student in an Organized Health Care Education/Training Program in Louisville, KY. Individual provider (NPI-1).
NPI number1164044384
StatusActive
Last updated in NPPESMay 8, 2022
Details
- NPI
- 1164044384
- Entity type
- Individual (NPI-1)
- Name
- Mr. Samuel Paul Bockhorst
- Credential
- MD Medical Student
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 11, 2020
- Certification date
- May 8, 2022
- Last updated
- May 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
500 S Preston St Rm 305Louisville, KY 40202-1702
Phone 502-852-8696
Mailing address
550 S Jackson St Fl Street3Louisville, KY 40202-1622
Phone 502-852-5666
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