| Blincoe & Shutt Psc | |
|
4122 Shelbyville Rd Louisville KY 40207-3242 | |
| (502) 895-2210 | |
| Not Available |
| Full Name | Blincoe & Shutt Psc |
|---|---|
| Speciality | Dentist |
| Location | 4122 Shelbyville Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Glenn R. Blincoe (PRESIDENT) |
| Authorized Official Contact | 5028952210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blincoe & Shutt Psc 4122 Shelbyville Rd Louisville KY 40207-3242 Ph: (502) 895-2210 | Blincoe & Shutt Psc 4122 Shelbyville Rd Louisville KY 40207-3242 Ph: (502) 895-2210 |
| NPI Number | 1306220140 |
|---|---|
| Provider Enumeration Date | 07/10/2015 |
| Last Update Date | 12/22/2016 |
| Medicare PECOS PAC ID | 2466762430 |
|---|---|
| Medicare Enrollment ID | O20151103001110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306220140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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