| Onemd St Matthews Pllc | |
|
112 Sears Ave Louisville KY 40207-5014 | |
| (502) 238-2163 | |
| (502) 238-2173 |
| Full Name | Onemd St Matthews Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 112 Sears Ave, Louisville, Kentucky |
| Authorized Official Name and Position | John Varga (PARTNER) |
| Authorized Official Contact | 5028997163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onemd St Matthews Pllc 2425 Lime Kiln Ln Louisville KY 40222-3462 Ph: (502) 899-7163 | Onemd St Matthews Pllc 112 Sears Ave Louisville KY 40207-5014 Ph: (502) 238-2163 |
| NPI Number | 1639594344 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/04/2014 |
| Medicare PECOS PAC ID | 3072732429 |
|---|---|
| Medicare Enrollment ID | O20140916002807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639594344 | NPI | - | NPPES |
| 000026447N | Other | KY | HUMANA |
| 110235213 | Other | KY | RAILROAD MEDICARE |
| 000000225513 | Other | KY | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34957 (Kentucky) | Primary |
| Provider Name | Kelley M Mcintyre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497710693 PECOS PAC ID: 2163470493 Enrollment ID: I20050104000440 |
| Provider Name | William A Currie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235194531 PECOS PAC ID: 5092758300 Enrollment ID: I20050701000463 |
| Provider Name | Patrick M Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235217639 PECOS PAC ID: 6507754850 Enrollment ID: I20060125000616 |
| Provider Name | Dawn L Courtenay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811032014 PECOS PAC ID: 6103900857 Enrollment ID: I20080220000177 |
| Provider Name | Christopher S. Mcclellan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174588651 PECOS PAC ID: 9830386242 Enrollment ID: I20101210001002 |
| Provider Name | Felicia Longenecker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710243217 PECOS PAC ID: 9638482573 Enrollment ID: I20150721001090 |
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