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General NPI Number Information
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NPI Number | 1871559286
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Entity Type | Organization
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Legal Business Name | U OF L RESEARCH FOUNDATION
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 CENTRAL AVE 200
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City | LOUISVILLE
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State | KY
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Zip | 40208
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Country | US
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Telephone | 502-637-9313
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Fax | 502-635-6317
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Provider Business Mailing Address
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Address Line | 501 E BROADWAY STE 120
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City | LOUISVILLE
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State | KY
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Zip | 40202
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Country | US
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Telephone | 502-562-6810
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Fax | 502-562-6777
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Authorized Official
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Title or Position | CHAIRMAN OF DEPT
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Name | JAMES OBRIEN
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Credential | MD
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Telephone | 502-852-5498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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