| Proactive Md Ky Psc | |
|
4340 Crittenden Dr Louisville KY 40209-1600 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | Proactive Md Ky Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 4340 Crittenden Dr, Louisville, Kentucky |
| Authorized Official Name and Position | Ben Stoner (EVP FINANCE & ADMINISTRATION) |
| Authorized Official Contact | 8645010815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Md Ky Psc 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive Md Ky Psc 4340 Crittenden Dr Louisville KY 40209-1600 Ph: (864) 501-0751 |
| NPI Number | 1548883960 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548883960 | NPI | - | NPPES |
| 1649359514 | Other | KY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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