| Associates In Gastroenterology Pllc | |
|
4402 Churchman Ave Suite 201, Plaza I Louisville KY 40215-1190 | |
| (502) 416-0207 | |
| (502) 416-0208 |
| Full Name | Associates In Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4402 Churchman Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Ashok Kapur (OWNER/PRESIDENT) |
| Authorized Official Contact | 5024160207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associates In Gastroenterology Pllc Po Box 950164 Louisville KY 40295-0164 Ph: (502) 814-3170 | Associates In Gastroenterology Pllc 4402 Churchman Ave Suite 201, Plaza I Louisville KY 40215-1190 Ph: (502) 416-0207 |
| NPI Number | 1932439064 |
|---|---|
| Provider Enumeration Date | 01/13/2010 |
| Last Update Date | 01/08/2020 |
| Medicare PECOS PAC ID | 5597950162 |
|---|---|
| Medicare Enrollment ID | O20101109000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932439064 | NPI | - | NPPES |
| 7100127400 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ashok Kapur |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356395859 PECOS PAC ID: 8224926241 Enrollment ID: I20040310000182 |
| Provider Name | Lisa Marie Wooten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033469366 PECOS PAC ID: 0547411761 Enrollment ID: I20121117000102 |
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