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General NPI Number Information
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NPI Number | 1225181639
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Entity Type | Organization
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Legal Business Name | LOUISVILLE NEUROSURGICAL SPECIALISTS, P.S.C.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4010 DUPONT CIR SUITE L-28
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City | LOUISVILLE
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State | KY
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Zip | 40207-4812
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Country | US
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Telephone | 502-899-9099
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Fax | 502-899-9899
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Provider Business Mailing Address
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Address Line | 4010 DUPONT CIR SUITE L-28
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City | LOUISVILLE
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State | KY
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Zip | 40207-4812
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Country | US
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Telephone | 502-899-9099
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Fax | 502-899-9899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ALEXANDER PETRUSKA
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Credential | M.D.
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Telephone | 502-899-9099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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