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General NPI Number Information
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NPI Number | 1659391563
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Entity Type | Organization
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Legal Business Name | LOUISVILLE SLEEP DISORDERS CENTER LLC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 4010 DUPONT CIR STE 122
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City | LOUISVILLE
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State | KY
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Zip | 40207-4842
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Country | US
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Telephone | 502-899-9199
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Fax | 502-899-1617
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Provider Business Mailing Address
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Address Line | 4010 DUPONT CIR STE 122
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City | LOUISVILLE
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State | KY
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Zip | 40207-4842
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Country | US
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Telephone | 502-899-9199
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Fax | 502-899-1617
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | THERESA HOLMES
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Credential |
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Telephone | 502-899-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 730067
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License Number State | KY
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