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General NPI Number Information
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NPI Number | 1801833140
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Entity Type | Organization
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Legal Business Name | KENTUCKIANA EMERGENCY PHYSICIANS, PLLC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 1 AUDUBON PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-636-7111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4778
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City | BLOOMINGTON
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State | IN
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Zip | 47402-4778
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Country | US
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Telephone | 812-336-1690
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Fax | 812-349-1311
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL D BISHOP
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Credential | MD
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Telephone | 877-889-3383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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