Healthcare Provider Details

I. General information

NPI: 1881785947
Provider Name (Legal Business Name): PSF PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 SHELBYVILLE RD STE 220
LOUISVILLE KY
40223
US

IV. Provider business mailing address

9800 SHELBYVILLE RD STE 220
LOUISVILLE KY
40223-2992
US

V. Phone/Fax

Practice location:
  • Phone: 502-429-8585
  • Fax: 855-656-7325
Mailing address:
  • Phone: 502-429-8585
  • Fax: 855-656-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: JAMES L SUBLETT
Title or Position: OWNER
Credential: MD
Phone: 502-429-8585