Provider Demographics
NPI:1316246085
Name:MORALES ALBERTERIS, IOSBANI ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:IOSBANI
Middle Name:ALBERTO
Last Name:MORALES ALBERTERIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6801 DIXIE HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-933-6400
Mailing Address - Fax:502-933-6406
Practice Address - Street 1:9616 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-3473
Practice Address - Country:US
Practice Address - Phone:502-933-6400
Practice Address - Fax:502-933-6406
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY47192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK151210Medicare PIN