| Mark Alan Puckett, | |
|
2400 Eastpoint Pkwy, Suite 110, Louisville, KY 40223-4154 | |
| (502) 253-6699 | |
| (502) 253-6670 |
| Full Name | Mark Alan Puckett |
|---|---|
| Gender | Male |
| Speciality | Sports Medicine |
| Experience | 16 Years |
| Location | 2400 Eastpoint Pkwy, Louisville, Kentucky |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649430794 | NPI | - | NPPES |
| 7100209760 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 45394 (Kentucky) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | 45394 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Health Louisville | Louisville, KY | Hospital |
| Norton Hospitals, Inc | Louisville, KY | Hospital |
| Baptist Health Lagrange | La grange, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baptist Health Medical Group Inc | 5597867184 | 1934 |
| Entity Name | Baptist Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740586213 PECOS PAC ID: 5597867184 Enrollment ID: O20070228000503 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Alan Puckett, 5200 Commerce Crossing, 3rd Floor, Louisville, KY 40229 Ph: (502) 253-4924 | Mark Alan Puckett, 2400 Eastpoint Pkwy, Suite 110, Louisville, KY 40223-4154 Ph: (502) 253-6699 |
Jaivanti Lohano, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2215 Portland Ave, Louisville, KY 40212 Phone: 502-774-8631 Fax: 502-778-3499 | |
John L Markert, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1169 Eastern Pkwy Ste 2265, Louisville, KY 40217 Phone: 502-635-7455 Fax: 502-634-9296 | |
Dr. Jerry Randolph Smith, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3015 Wilson Ave, Park Duvalle Cnc, Louisville, KY 40211 Phone: 502-774-4401 Fax: 502-772-4783 | |
Dr. Jill Marie Jacobs, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 8019 Dixie Hwy Ste 101, Louisville, KY 40258 Phone: 502-254-3898 | |
Chassidy Weatherford, APRN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4950 Norton Healthcare Blvd, Louisville, KY 40241 Phone: 502-394-6350 | |
Michael James Gaffney, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3532 Ephraim Mcdowell Drive, Louisville, KY 40205 Phone: 502-456-6200 Fax: 502-456-6655 | |
Veronica Anne Kavorkian, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2701 Chamberlain Ln, Louisville, KY 40245 Phone: 502-243-9044 Fax: 502-243-8482 |