Healthcare Provider Details

I. General information

NPI: 1164442604
Provider Name (Legal Business Name): LOUISVILLE ENDOCRINE CONSULTANTS, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BLUEGRASS AVENUE SUITE 108
LOUISVILLE KY
40215-1144
US

IV. Provider business mailing address

720 W. BROADWAY SUITE 202
LOUISVILLE KY
40202-3245
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-2524
  • Fax: 502-361-2525
Mailing address:
  • Phone: 502-238-9911
  • Fax: 502-238-9912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN KARNES
Title or Position: BILLING SUPERVISOR
Credential: CPC
Phone: 502-238-9911