Healthcare Provider Details

I. General information

NPI: 1972728186
Provider Name (Legal Business Name): LOUIS GREGORY MERIWETHER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 KRESGE WAY SUITE 60
LOUISVILLE KY
40207-4660
US

IV. Provider business mailing address

PO BOX 950248
LOUISVILLE KY
40295-0248
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-7710
  • Fax: 502-893-1884
Mailing address:
  • Phone: 502-489-5730
  • Fax: 502-489-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number40161
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: