Healthcare Provider Details
I. General information
NPI: 1922081546
Provider Name (Legal Business Name): KENTUCKIANA CENTER FOR BETTER BONE & JOINT HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2005
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 EAST LIBERTY STREET SUITE 700
LOUISVILLE KY
40202-1426
US
IV. Provider business mailing address
100 E LIBERTY ST SUITE 700
LOUISVILLE KY
40202-1426
US
V. Phone/Fax
- Phone: 502-583-5836
- Fax: 502-583-2266
- Phone: 502-583-5836
- Fax: 502-583-2266
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
H.
STERN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 502-583-5836