MEDICARE: LOUISVILLE MEDICAL CENTER PHYSICIANS INC.

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760452585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISVILLE MEDICAL CENTER PHYSICIANS INC.

Provider Business Mailing Address
First Line	:	1909 WILLIAMSBURG WAY NE
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-8781
Country	:	US
Telephone Number	:	330-875-3366
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 WILLIAMSBURG WAY NE
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-8781
Country	:	US
Telephone Number	:	330-875-3366
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TERRENCE L. PANSINO
Credential	:	M.D.
Telephone Number	:	330-875-3366

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	10/09/2008

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