Basic Information
Provider Information
NPI: 1174567382
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABELL
FirstName: THOMAS
MiddleName: LYMAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 909
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402010909
CountryCode: US
TelephoneNumber: 5025880320
FaxNumber: 5025880326
Practice Location
Address1: 401 E CHESTNUT ST UNIT 310
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402025703
CountryCode: US
TelephoneNumber: 5025884710
FaxNumber: 5025884771
Other Information
ProviderEnumerationDate: 06/16/2006
LastUpdateDate: 02/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X17377MSY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207R00000X45463KYN Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
6403510805KY MEDICAID


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