Healthcare Provider Details

I. General information

NPI: 1225549678
Provider Name (Legal Business Name): ORTHOPEDIC HAND AND ARM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 EASTERN PKWY STE 1220
LOUISVILLE KY
40217-1462
US

IV. Provider business mailing address

1169 EASTERN PKWY STE 1220
LOUISVILLE KY
40217-1462
US

V. Phone/Fax

Practice location:
  • Phone: 502-883-3313
  • Fax: 502-883-3338
Mailing address:
  • Phone: 502-883-3313
  • Fax: 502-883-3338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number44950
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number44950
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. LEELA FARR
Title or Position: OWNER
Credential: MD
Phone: 502-883-3313