Healthcare Provider Details

I. General information

NPI: 1285760371
Provider Name (Legal Business Name): EMERGENCY MEDICAL ASSOCIATES, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 DUTCHMANS LN
LOUISVILLE KY
40207-4714
US

IV. Provider business mailing address

29478 NETWORK PL
CHICAGO IL
60673-1294
US

V. Phone/Fax

Practice location:
  • Phone: 502-895-4607
  • Fax: 502-895-4586
Mailing address:
  • Phone: 502-895-4607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN CAWOOD
Title or Position: MD
Credential: MD
Phone: 502-895-4607