| Kentucky Joint Specialists Llc | |
|
4010 Dupont Cir Ste 310 Louisville KY 40207-4834 | |
| (502) 771-5432 | |
| (502) 771-5430 |
| Full Name | Kentucky Joint Specialists Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4010 Dupont Cir Ste 310, Louisville, Kentucky |
| Authorized Official Name and Position | Kenneth Hartog (OWNER) |
| Authorized Official Contact | 5027715432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Joint Specialists Llc 4010 Dupont Cir Ste 310 Louisville KY 40207-4834 Ph: (502) 771-5432 | Kentucky Joint Specialists Llc 4010 Dupont Cir Ste 310 Louisville KY 40207-4834 Ph: (502) 771-5432 |
| NPI Number | 1013670173 |
|---|---|
| Provider Enumeration Date | 10/15/2021 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0446641518 |
|---|---|
| Medicare Enrollment ID | O20211228000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013670173 | NPI | - | NPPES |
| Provider Name | Wendy Mullins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588702724 PECOS PAC ID: 1456416478 Enrollment ID: I20090206000533 |
| Provider Name | Susan Scuffle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457839102 PECOS PAC ID: 9032461280 Enrollment ID: I20181016003130 |
| Provider Name | Laura Purdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093058463 PECOS PAC ID: 9133556624 Enrollment ID: I20200728001834 |
| Provider Name | Jennifer Lea Blackburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710502703 PECOS PAC ID: 3173914249 Enrollment ID: I20211228000771 |
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