MEDICARE: ELLIS & BADENHAUSEN ORTHOPAEDICS,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
1	207X00000X	Orthopaedic Surgery Physician		KY
2	332B00000X	Durable Medical Equipment & Medical Supplies	079020	KY
3	363A00000X	Physician Assistant
4	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1881702546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIS & BADENHAUSEN ORTHOPAEDICS,PSC

Provider Business Mailing Address
First Line	:	13151 MAGISTERIAL DR
Second Line	:	SUITE 200
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-4103
Country	:	US
Telephone Number	:	502-587-1236
Fax Number	:	502-587-0126

Provider Business Practice Location Address
First Line	:	5120 DIXIE HWY
Second Line	:	SUITE 103
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-1702
Country	:	US
Telephone Number	:	502-449-0449
Fax Number	:	502-449-3277

Authorized Official
Title or Position	:	DIRECTOR OF BILLING
Name	:	LACIE CURL
Credential	:
Telephone Number	:	502-587-1236

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	04/19/2023

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Directions to “ELLIS & BADENHAUSEN ORTHOPAEDICS,PSC ” Practice Location

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