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General NPI Number Information
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NPI Number | 1326292996
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Entity Type | Organization
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Legal Business Name | UFPA CENTER FOR PRIMARY CARE
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 215 CENTRAL AVE STE 205
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City | LOUISVILLE
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State | KY
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Zip | 40208-1449
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Country | US
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Telephone | 502-852-3322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | LOUISVILLE
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State | KY
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Zip | 40201-0909
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Country | US
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Telephone | 502-852-5205
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Fax | 500-285-2540
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Authorized Official
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Title or Position | PRESIDENT/DEPARTMENT CHAIR
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Name | DR. JAMES G. O'BRIEN
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Credential | MD
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Telephone | 502-852-8498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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