| Louisville Endocrinology Psc | |
|
3288 Illinois Ave Suite 100 Louisville KY 40213 | |
| (502) 515-6621 | |
| (502) 515-6620 |
| Full Name | Louisville Endocrinology Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3288 Illinois Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Deborah Ann Ballard (PHYSICIAN PRESIDENT) |
| Authorized Official Contact | 5025156621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Endocrinology Psc 3288 Illinois Ave Suite 101 Louisville KY 40213 Ph: (502) 515-6621 | Louisville Endocrinology Psc 3288 Illinois Ave Suite 100 Louisville KY 40213 Ph: (502) 515-6621 |
| NPI Number | 1295852317 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295852317 | NPI | - | NPPES |
| 000000227457 | Other | ANTHEM | |
| 1162678 | Other | PASSPORT | |
| 2439678000 | Other | PASSPORT ADVANTAGE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | KY26476 (Kentucky) | Primary |
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