| Commonwealth Infectious Disease Psc | |
|
3910 S Dupont Sq Suite A Louisville KY 40207-4615 | |
| (502) 896-8299 | |
| Not Available |
| Full Name | Commonwealth Infectious Disease Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3910 S Dupont Sq, Louisville, Kentucky |
| Authorized Official Name and Position | Eric Xia (PRESIDENT) |
| Authorized Official Contact | 8129485159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Infectious Disease Psc Po Box 32172 Louisville KY 40232-2172 Ph: (502) 896-8299 | Commonwealth Infectious Disease Psc 3910 S Dupont Sq Suite A Louisville KY 40207-4615 Ph: (502) 896-8299 |
| NPI Number | 1649232026 |
|---|---|
| Provider Enumeration Date | 04/03/2006 |
| Last Update Date | 07/01/2020 |
| Medicare PECOS PAC ID | 0749239226 |
|---|---|
| Medicare Enrollment ID | O20050121000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649232026 | NPI | - | NPPES |
| 65905838 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 33270 (Kentucky) | Primary |
| Provider Name | Thomas J Spech |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215999131 PECOS PAC ID: 8820047301 Enrollment ID: I20050121000819 |
| Provider Name | Eric L Xia |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346202264 PECOS PAC ID: 3678607397 Enrollment ID: I20100817001186 |
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