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General NPI Number Information
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NPI Number | 1326357120
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Entity Type | Organization
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Legal Business Name | LOUISVILLE CARE CENTER INC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 9700 STONESTREET RD
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City | LOUISVILLE
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State | KY
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Zip | 40272-2884
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Country | US
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Telephone | 502-380-7052
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Fax |
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Provider Business Mailing Address
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Address Line | 6661 DIXIE HWY UNIT 4-333
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City | LOUISVILLE
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State | KY
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Zip | 40258-3950
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Country | US
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Telephone | 502-380-7052
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOHN G HUBBARD
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Credential | M.D.
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Telephone | 502-380-7052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 16325
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License Number State | KY
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