Healthcare Provider Details

I. General information

NPI: 1770506438
Provider Name (Legal Business Name): ROBERT F DEBSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 E CHESTNUT ST PATHOLOGY DEPT
LOUISVILLE KY
40202-1821
US

IV. Provider business mailing address

1941 BISHOP LN STE 1018
LOUISVILLE KY
40218-1928
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-7900
  • Fax: 502-456-4440
Mailing address:
  • Phone: 502-456-6211
  • Fax: 502-456-4440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number39593
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number39593
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: