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General NPI Number Information
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NPI Number | 1780115998
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Entity Type | Organization
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Legal Business Name | PRESTON URGENT CARE, INC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 4822 PRESTON HWY
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City | LOUISVILLE
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State | KY
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Zip | 40213-2226
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Country | US
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Telephone | 502-969-2227
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Fax | 502-587-0390
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Provider Business Mailing Address
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Address Line | 4822 PRESTON HWY
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City | LOUISVILLE
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State | KY
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Zip | 40213-2226
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Country | US
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Telephone | 502-969-2227
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Fax | 502-587-0390
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Authorized Official
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Title or Position | MD
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Name | MISS MISHA HAQ
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Credential |
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Telephone | 502-969-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33462
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 32576
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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