| Pediatric Gastroenterology Psc | |
|
233 E Gray St Suite 513 Louisville KY 40202-2026 | |
| (502) 629-5796 | |
| (502) 629-5799 |
| Full Name | Pediatric Gastroenterology Psc |
|---|---|
| Speciality | Clinic/center |
| Location | 233 E Gray St, Louisville, Kentucky |
| Authorized Official Name and Position | Thgmas C Stephen (PRESIDENT) |
| Authorized Official Contact | 5026295796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Gastroenterology Psc 233 E Gray St Suite 513 Louisville KY 40202-2026 Ph: (502) 629-5796 | Pediatric Gastroenterology Psc 233 E Gray St Suite 513 Louisville KY 40202-2026 Ph: (502) 629-5796 |
| NPI Number | 1164455952 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 05/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164455952 | NPI | - | NPPES |
| 1049092 | Other | KY | PASSPORT GROUP NUMBER |
| 200140610A | Medicaid | IN | |
| 65927816 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0424168 (Kentucky) | Primary |
Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15103 Chestnut Ridge Cir, Louisville, KY 40245 Phone: 502-742-9149 Fax: 502-896-7292 | |
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Kentucky Joint Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4010 Dupont Cir Ste 310, Louisville, KY 40207 Phone: 502-771-5432 Fax: 502-771-5430 | |
Mobile Md Holdings Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9510 Ormsby Station Road, Suite 100b, Louisville, KY 40223 Phone: 502-253-4140 | |
Edina Torlak Md, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 Kresge Way Ste 302, Louisville, KY 40207 Phone: 502-893-7372 | |
Shirley J Meredith, Md, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4000 Kresge Way, Baptist East Wound Care Center, Louisville, KY 40207 Phone: 502-259-4470 Fax: 502-259-4471 | |
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