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NPI Code Detail

MEDICARE: ANDREW J WEST M.D.

MEDICARE: ANDREW J WEST 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
1207N00000XDermatology Physician32374KY
2207ND0900XDermatopathology Physician32374KY
3207ND0101XMOHS-Micrographic Surgery Physician32374KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24884OTHERKYGROUP MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12436690000OTHERKYPASSPORT ADVANTAGE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41110678OTHERKYPASSPORT

General Provider Information

NPI Number : 1376631580
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW J WEST M.D.
Provider Business Mailing Address
First Line : PO BOX 950266
Second Line :
City : LOUISVILLE
State : KY
Zip : 40295-0266
Country : US
Telephone Number : 502-896-6355
Fax Number : 502-896-9813
Provider Business Practice Location Address
First Line : 2811 KLEMPNER WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-4203
Country : US
Telephone Number : 502-896-6355
Fax Number : 502-896-9813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 06/09/2020

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