Provider Demographics
NPI:1194481358
Name:KORTE, ERIK (PHD, DABCC)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:KORTE
Suffix:
Gender:M
Credentials:PHD, DABCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-7248
Mailing Address - Country:US
Mailing Address - Phone:502-538-2980
Mailing Address - Fax:
Practice Address - Street 1:221 S BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:MOUNT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7248
Practice Address - Country:US
Practice Address - Phone:502-538-2980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1262247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician