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Victor Jose Anciano Granadillo, MD

Orthopaedic Surgery in Louisville, KY. Individual provider (NPI-1).

NPI number1841686995
StatusActive
Last updated in NPPESAug 24, 2021

Details

NPI
1841686995
Entity type
Individual (NPI-1)
Name
Victor Jose Anciano Granadillo
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 15, 2015
Certification date
Aug 24, 2021
Last updated
Aug 24, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery55434KYYes

Practice location

4402 Churchman Ave Ste 300
Louisville, KY 40215-3101

Phone 502-363-0588 · Fax 502-363-0972

Mailing address

Po Box 909
Louisville, KY 40201-0909

Phone 502-588-0328

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