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NPI Code Detail

MEDICARE: LOUIS R KIRTLEY M.D.

MEDICARE: LOUIS R KIRTLEY 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
1207VG0400XGynecology Physician20700KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P01140466OTHERKYMEDICARE RR - WS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20700073OTHERKYUNITED HEALTHCARE
3160032458OTHERKYRAILROAD
51063797OTHERKYPASSPORT
650036613OTHERKYPASSPORT - WS

General Provider Information

NPI Number : 1578568739
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIS R KIRTLEY M.D.
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5116
Provider Business Practice Location Address
First Line : 4130 DUTCHMANS LN
Second Line : STE 400
City : LOUISVILLE
State : KY
Zip : 40207-4711
Country : US
Telephone Number : 502-897-0697
Fax Number : 502-897-0658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 06/20/2019

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Directions to “ LOUIS R KIRTLEY M.D.” Practice Location

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