| S Kapoor Pllc | |
|
2109 Club Vista Pl Louisville KY 40245-5224 | |
| (502) 602-4620 | |
| Not Available |
| Full Name | S Kapoor Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2109 Club Vista Pl, Louisville, Kentucky |
| Authorized Official Name and Position | Kaylee James (DIRECTOR OF REVENUE) |
| Authorized Official Contact | 5026024620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S Kapoor Pllc 2109 Club Vista Pl Louisville KY 40245-5224 Ph: (502) 602-4620 | S Kapoor Pllc 2109 Club Vista Pl Louisville KY 40245-5224 Ph: (502) 602-4620 |
| NPI Number | 1558090688 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 06/06/2022 |
| Medicare PECOS PAC ID | 6305221334 |
|---|---|
| Medicare Enrollment ID | O20220912002837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558090688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sandeep Kapoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043264641 PECOS PAC ID: 9638206683 Enrollment ID: I20100422000463 |
| Provider Name | Ragan N Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023307741 PECOS PAC ID: 5991989808 Enrollment ID: I20110418000223 |
| Provider Name | Jeffery Allan Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962097428 PECOS PAC ID: 8628476926 Enrollment ID: I20211015002197 |
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