| Thomas Health Services Kentucky P.s.c. | |
|
312 S 4th Street Ste 700 Pmb 3849 Louisville KY 40202-3046 | |
| (310) 360-7200 | |
| Not Available |
| Full Name | Thomas Health Services Kentucky P.s.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 312 S 4th Street Ste 700, Louisville, Kentucky |
| Authorized Official Name and Position | Mottsin Thomas (PRESIDENT) |
| Authorized Official Contact | 3108662571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Health Services Kentucky P.s.c. 1590 Rosecrans Ave # D-617 Manhattan Beach CA 90266-3727 Ph: (310) 360-7200 | Thomas Health Services Kentucky P.s.c. 312 S 4th Street Ste 700 Pmb 3849 Louisville KY 40202-3046 Ph: (310) 360-7200 |
| NPI Number | 1730885351 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/05/2023 |
| Medicare PECOS PAC ID | 6901250067 |
|---|---|
| Medicare Enrollment ID | O20230925000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730885351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mottsin Lawrence Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376885293 PECOS PAC ID: 1052690351 Enrollment ID: I20231024001806 |
| Provider Name | Mehdi Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548938467 PECOS PAC ID: 0648615906 Enrollment ID: I20240321003821 |
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