Healthcare Provider Details
I. General information
NPI: 1316537533
Provider Name (Legal Business Name): LOUISVILLE HIP AND KNEE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2021
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3810 SPRINGHURST BLVD
LOUISVILLE KY
40241-6162
US
IV. Provider business mailing address
3810 SPRINGHURST BLVD STE 310
LOUISVILLE KY
40241-6162
US
V. Phone/Fax
- Phone: 502-905-0695
- Fax:
- Phone: 502-905-0695
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENISE
E
KIRKHAM
Title or Position: EXECUTIVE DIRECTOR/CONSULTANT
Credential:
Phone: 502-905-0695