Healthcare Provider Details

I. General information

NPI: 1942231626
Provider Name (Legal Business Name): UOFL RESEARCH FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S JACKSON ST 2ND FLOOR, ACB
LOUISVILLE KY
40202-1622
US

IV. Provider business mailing address

501 E BROADWAY STE 120
LOUISVILLE KY
40202-1785
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-8844
  • Fax: 502-561-8843
Mailing address:
  • Phone: 502-562-6810
  • Fax: 502-562-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES O'BRIEN
Title or Position: CHAIRMAN OF DEPARTMENT
Credential:
Phone: 502-562-6783