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NPI Code Detail

MEDICARE: RECOVERY CARE PLLC

MEDICARE: RECOVERY CARE PLLC
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
1207R00000XInternal Medicine Physician861121775KY

General Provider Information

NPI Number : 1700885878
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECOVERY CARE PLLC
Provider Business Mailing Address
First Line : 411 WATCH HILL LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-2201
Country : US
Telephone Number : 502-303-4138
Fax Number : 502-385-6615
Provider Business Practice Location Address
First Line : 227 BROWNS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-3215
Country : US
Telephone Number : 502-893-2595
Fax Number : 502-895-1811
Authorized Official
Title or Position : PRESIDENT
Name : RAVI GILL
Credential : MD
Telephone Number : 502-303-4138
Provider Enumeration Date : 07/20/2005
Last Update Date : 05/03/2022

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Directions to “RECOVERY CARE PLLC ” Practice Location

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