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Organization
LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC
Active
Organization
LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES D. CHARASIKA M.D. (PRESIDENT/CEO)
(502) 896-8041
Entity
Organization
Contact information
Practice address
4010 DUPONT CIR, SUITE 308, LOUISVILLE, KY 40207-4812
(502) 896-8041
(502) 896-8044
Mailing address
4010 DUPONT CIR, SUITE 308, LOUISVILLE, KY 40207-4812
(502) 896-8041
(502) 896-8044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18988
KY
261QP2300X
Primary Care Clinic/Center
18988
KY
Other
Enumeration date
03/25/2008
Last updated
12/27/2013
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