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General NPI Number Information
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NPI Number | 1396726675
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Entity Type | Individual
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Provider Name | BRUCE J TASCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 6000 BROWNSBORO PARK BLVD SUITE G
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City | LOUISVILLE
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State | KY
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Zip | 40207-7201
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Country | US
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Telephone | 502-899-9560
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Fax | 502-899-9561
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Provider Business Mailing Address
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Address Line | 6000 BROWNSBORO PARK BLVD SUITE G
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City | LOUISVILLE
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State | KY
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Zip | 40207-7201
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Country | US
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Telephone | 502-899-9560
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Fax | 502-899-9561
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 22305
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License Number State | KY
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