Healthcare Provider Details

I. General information

NPI: 1811524309
Provider Name (Legal Business Name): STEPHANIE PAIGE MCGEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE PAIGE MILES MD

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 SHELBYVILLE RD STE 2
LOUISVILLE KY
40243-1538
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-245-4301
  • Fax: 502-394-3632
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number58095
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125076132
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: