Healthcare Provider Details

I. General information

NPI: 1295964484
Provider Name (Legal Business Name): KALI SVARCZKOPF GERACE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALI SVARCZKOPF

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2944 BRECKENRIDGE LN
LOUISVILLE KY
40220-1409
US

IV. Provider business mailing address

2944 BRECKENRIDGE LN
LOUISVILLE KY
40220-1409
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-0159
  • Fax: 502-213-3853
Mailing address:
  • Phone: 502-893-0159
  • Fax: 502-213-3853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberTP387
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number48186
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: