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General NPI Number Information
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NPI Number | 1952778151
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Entity Type | Organization
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Legal Business Name | DR. PADMAPRIYA BALAKRISHNA M. D.
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 10300 LINN STATION RD SUITE 400
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City | LOUISVILLE
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State | KY
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Zip | 40223-3840
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Country | US
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Telephone | 502-494-4718
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Fax | 888-577-7895
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Provider Business Mailing Address
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Address Line | 10300 LINN STATION RD SUITE 400
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City | LOUISVILLE
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State | KY
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Zip | 40223-3840
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Country | US
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Telephone | 502-494-4718
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Fax | 888-577-7895
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Authorized Official
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Title or Position | OWNER
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Name | PADMAPRIYA BALAKRISHNA
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Credential | M. D.
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Telephone | 502-494-4718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 37367
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License Number State | KY
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