| Southend Gastroenterology Associates Pllc | |
|
4402 Churchman Ave Ste 408 Louisville KY 40215-1190 | |
| (502) 365-5140 | |
| Not Available |
| Full Name | Southend Gastroenterology Associates Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4402 Churchman Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Sanjay K Jain (OWNER) |
| Authorized Official Contact | 5028914000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southend Gastroenterology Associates Pllc 2503 Bush Ridge Dr A Louisville KY 40245-5885 Ph: (502) 819-4000 | Southend Gastroenterology Associates Pllc 4402 Churchman Ave Ste 408 Louisville KY 40215-1190 Ph: (502) 365-5140 |
| NPI Number | 1932438272 |
|---|---|
| Provider Enumeration Date | 12/16/2009 |
| Last Update Date | 05/17/2019 |
| Medicare PECOS PAC ID | 7911032677 |
|---|---|
| Medicare Enrollment ID | O20100319000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932438272 | NPI | - | NPPES |
| 000000644156 | Other | ANTHEM | |
| 201118680 | Medicaid | IN | |
| 7956992 | Other | AETNA | |
| 7100101260 | Medicaid | KY | |
| 50027327 | Other | KY | PASSPORT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Sanjay K Jain |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578504817 PECOS PAC ID: 0244212926 Enrollment ID: I20040701000448 |
| Provider Name | Bao Tram C Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043575749 PECOS PAC ID: 1850516972 Enrollment ID: I20140703001823 |
| Provider Name | Katherine M Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536505 PECOS PAC ID: 8325354186 Enrollment ID: I20150825004227 |
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 | |
Veloz Medical Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6911 Shepherdsville Rd, Louisville, KY 40219 Phone: 502-644-3076 | |
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 | |
Infectious Disease Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Locust Creek Blvd, Louisville, KY 40245 Phone: 502-916-3130 Fax: 502-916-3230 |