| Md2u Doctors Who Make House Calls | |
|
105 Crescent Ave Louisville KY 40206-1525 | |
| (502) 327-9100 | |
| (502) 742-3767 |
| Full Name | Md2u Doctors Who Make House Calls |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 105 Crescent Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Gregory David Latta (BILLING MANAGER) |
| Authorized Official Contact | 5023279100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Md2u Doctors Who Make House Calls 105 Crescent Ave Louisville KY 40206-1525 Ph: (502) 327-9100 | Md2u Doctors Who Make House Calls 105 Crescent Ave Louisville KY 40206-1525 Ph: (502) 327-9100 |
| NPI Number | 1578576690 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 06/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578576690 | NPI | - | NPPES |
| 000000365262 | Other | KY | BCBS PIN |
| DD3382 | Other | KY | RAILROAD MEDICARE PIN |
| 50007387 | Other | KY | PASSPORT # |
| 2448540000 | Other | KY | PASSPORT ADVANTAGE # |
| 7100037890 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 38836 (Kentucky) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 01056286A (Indiana) | Secondary |
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