MEDICARE: LOUISE M BOX 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
1	208D00000X	General Practice Physician	29848	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00219045	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000014952X	OTHER		HUMANA / NCMA
2	2446866000	OTHER	KY	PASSPORT ADVANTAGE - NCMA
3	50005562	OTHER	KY	PASSPORT - NCMA
4	50025010	OTHER		PASSPORT / NCMA TYLER
5	7398219	OTHER		CIGNA / NCMA
7	048233	OTHER		SIHO / NCMA
8	2446866000	OTHER		PASSPORT ADVANTAGE / NCMA -TYLER
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	1194518	OTHER		CHA / NCMA
11	0000350819	OTHER	KY	ANTHEM - NCMA
12	3729659000	OTHER	KY	PASSPORT ADVANGATE - TYLER

General Provider Information

NPI Number	:	1578528246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE M BOX M.D.

Provider Business Mailing Address
First Line	:	PO BOX 950202
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0202
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	12615 TAYLORSVILLE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-4452
Country	:	US
Telephone Number	:	502-261-1595
Fax Number	:	502-261-1599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	11/10/2014

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Directions to “ LOUISE M BOX M.D.” Practice Location

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