| Michael Alt Do Psc | |
|
2934 Breckenridge Ln Ste 2 Louisville KY 40220-3903 | |
| (502) 454-7871 | |
| (502) 454-7872 |
| Full Name | Michael Alt Do Psc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2934 Breckenridge Ln Ste 2, Louisville, Kentucky |
| Authorized Official Name and Position | Michael Alt (OWNER) |
| Authorized Official Contact | 5028975997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Alt Do Psc 2934 Breckenridge Ln Ste 2 Louisville KY 40220-3903 Ph: (502) 454-7871 | Michael Alt Do Psc 2934 Breckenridge Ln Ste 2 Louisville KY 40220-3903 Ph: (502) 454-7871 |
| NPI Number | 1508030032 |
|---|---|
| Provider Enumeration Date | 04/16/2008 |
| Last Update Date | 04/17/2014 |
| Medicare PECOS PAC ID | 7012087745 |
|---|---|
| Medicare Enrollment ID | O20080606000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508030032 | NPI | - | NPPES |
| 64022452 | Medicaid | KY | |
| 50018842 | Other | KY | PASSPORT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Michael G Alt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740227255 PECOS PAC ID: 1759451487 Enrollment ID: I20080606000039 |
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