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NPI Code Detail

MEDICARE: FAMILY CARE PHYSICIANS, PSC

MEDICARE: FAMILY CARE PHYSICIANS, PSC
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
1363L00000XNurse Practitioner3007878KY

General Provider Information

NPI Number : 1568868107
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY CARE PHYSICIANS, PSC
Provider Business Mailing Address
First Line : 2701 CHAMBERLAIN LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-1603
Country : US
Telephone Number : 502-243-9044
Fax Number : 502-243-8482
Provider Business Practice Location Address
First Line : 2701 CHAMBERLAIN LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-1603
Country : US
Telephone Number : 502-243-9044
Fax Number : 502-243-8482
Authorized Official
Title or Position : OFFICE MANAGER
Name : TONYA JESSE
Credential :
Telephone Number : 502-243-9044
Provider Enumeration Date : 11/10/2014
Last Update Date : 11/10/2014

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Directions to “FAMILY CARE PHYSICIANS, PSC ” Practice Location

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