| Doctor Name: | MR. ERNEST JOHN MIKE |
| NPI Number: | 1336303932 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPA |
| License Number: | 100564017 |
| Business Practice Address: | 5000 Sumerlin Ct Buckner, KY - 400108845 |
| Business Phone Number: | 5026642998 |
| Business Fax Number: | |
| Mailing Address: | 5000 Sumerlin Ct, BUCKNER |
| State: | KY |
| Postal Code: | 400108845 |
| Phone Number: | 5026642998 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2008 |
| NPI Last Update Date: | 07/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471V0106X |
| License Number: | 100564017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Vascular-Interventional Technology |
| Taxonomy Definition: | |