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General NPI Number Information
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NPI Number | 1336707512
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF LOUISVILLE PHYISICIANS, INC.
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 530 S JACKSON ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1675
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Country | US
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Telephone | 502-562-3000
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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 | 502-588-0320
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Fax |
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Authorized Official
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Title or Position | SR VP/CONTRACTING & CREDENTIALING
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Name | PAUL NAGY
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Credential |
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Telephone | 502-588-4210
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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