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General NPI Number Information
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NPI Number | 1538202288
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Entity Type | Organization
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Legal Business Name | LOUISVILLE INFECTIOUS DISEASE AND INTERNAL MEDICINE
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 E LIBERTY ST 800
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City | LOUISVILLE
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State | KY
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Zip | 40202-1530
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Country | US
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Telephone | 502-581-0087
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Fax | 502-581-0816
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Provider Business Mailing Address
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Address Line | 250 E LIBERTY ST 800
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City | LOUISVILLE
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State | KY
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Zip | 40202-1530
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Country | US
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Telephone | 502-581-0087
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Fax | 502-581-0816
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. JOHN AARON VANARSDALL II
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Credential | M.D.
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Telephone | 502-581-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 18569
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License Number State | KY
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