| Lagrange Family Care Doctors P.s.c. | |
|
501 Parker Pl Suite 200 La Grange KY 40031-2223 | |
| (502) 222-7144 | |
| (502) 222-2034 |
| Full Name | Lagrange Family Care Doctors P.s.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 501 Parker Pl, La Grange, Kentucky |
| Authorized Official Name and Position | Plavakeerthi Kemparajurs (M.D./OWNER) |
| Authorized Official Contact | 5022227144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagrange Family Care Doctors P.s.c. 501 Parker Pl Suite 200 La Grange KY 40031-2223 Ph: (502) 222-7144 | Lagrange Family Care Doctors P.s.c. 501 Parker Pl Suite 200 La Grange KY 40031-2223 Ph: (502) 222-7144 |
| NPI Number | 1487766010 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 04/27/2020 |
| Medicare PECOS PAC ID | 1456320837 |
|---|---|
| Medicare Enrollment ID | O20041001000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487766010 | NPI | - | NPPES |
| 64258189 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Plavakeerthi Kemparajurs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750371969 PECOS PAC ID: 8628047008 Enrollment ID: I20041001000857 |
| Provider Name | Brian Jochim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306109327 PECOS PAC ID: 4284884230 Enrollment ID: I20121029000052 |
| Provider Name | Samyuktha Kemparajurs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902347313 PECOS PAC ID: 4284984030 Enrollment ID: I20181101001354 |
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