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General NPI Number Information
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NPI Number | 1437539145
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Entity Type | Organization
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Legal Business Name | SUNSHINE PEDIATRICS OF LOUISVILLE LLC
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 822 S MAYO TRL
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City | PAINTSVILLE
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State | KY
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Zip | 41240-1384
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Country | US
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Telephone | 606-789-5541
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Fax | 606-789-9445
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Provider Business Mailing Address
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Address Line | 191 MASJID AVE
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City | PRESTONSBURG
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State | KY
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Zip | 41653-8634
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Country | US
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Telephone | 606-789-5541
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Fax | 606-789-9445
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Authorized Official
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Title or Position | BILLING OFFICE MANAGER
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Name | CARLA F BRANCH
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Credential |
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Telephone | 606-789-5541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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