MEDICARE: DR. STEPHEN P MAKK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	28039	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629070545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN P MAKK M.D.

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSINGS DR FL 3
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2182
Country	:	US
Telephone Number	:	502-253-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 KRESGE WAY
Second Line	:	SUITE 100
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4640
Country	:	US
Telephone Number	:	502-897-6579
Fax Number	:	502-357-1682

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/08/2020

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