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NPI Code Detail

MEDICARE: MICHAEL CARL HESS M.D.

MEDICARE: MICHAEL CARL HESS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician19773KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00298562OTHERKYRR MEDICARE

General Provider Information

NPI Number : 1083615207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL CARL HESS M.D.
Provider Business Mailing Address
First Line : PO BOX 950202
Second Line :
City : LOUISVILLE
State : KY
Zip : 40295-0202
Country : US
Telephone Number : 502-969-6552
Fax Number : 502-969-3799
Provider Business Practice Location Address
First Line : 5334 S 3RD ST
Second Line : SOUTHEND MEDICAL CENTER
City : LOUISVILLE
State : KY
Zip : 40214-2612
Country : US
Telephone Number : 502-367-2288
Fax Number : 502-367-0108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 04/29/2008

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