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General NPI Number Information
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NPI Number | 1881932028
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Entity Type | Organization
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Legal Business Name | JEFFERSONTOWN MEDICAL PLLC
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 10131 TAYLORSVILLE RD
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City | JEFFERSONTOWN
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State | KY
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Zip | 40299-3649
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Country | US
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Telephone | 502-267-6444
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Fax | 502-267-6445
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Provider Business Mailing Address
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Address Line | 10131 TAYLORSVILLE RD
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City | JEFFERSONTOWN
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State | KY
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Zip | 40299-3649
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Country | US
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Telephone | 502-267-6444
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Fax | 502-267-6445
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Authorized Official
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Title or Position | PRESIDENT
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Name | NEIL P LANGSCHIED
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Credential | DC
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Telephone | 502-267-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 43136
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA758
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 43136
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 43136
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License Number State | KY
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