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Organization
DIXIE PRIMARY CARE LLC
Active
Organization
DIXIE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR SHPILBERG MD (OWNER)
(502) 937-3155
Entity
Organization
Contact information
Practice address
8033 DIXIE HWY, LOUISVILLE, KY 40258-1344
(502) 937-3155
(502) 935-0743
Mailing address
8033 DIXIE HWY, LOUISVILLE, KY 40258-1344
(502) 937-3155
(502) 935-0743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D1106923
CLIA
KY
Enumeration date
09/30/2009
Last updated
01/11/2010
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