Healthcare Provider Details

I. General information

NPI: 1144456757
Provider Name (Legal Business Name): IYER NEUROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 BUSH RIDGE DR SUITE A
LOUISVILLE KY
40245-5885
US

IV. Provider business mailing address

2505 BUSH RIDGE DR SUITE A
LOUISVILLE KY
40245-5885
US

V. Phone/Fax

Practice location:
  • Phone: 502-708-1338
  • Fax: 502-708-1339
Mailing address:
  • Phone: 502-708-1338
  • Fax: 502-708-1339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VASUDEVA IYER
Title or Position: MEMBER
Credential: MD
Phone: 502-708-1338