# SUSAN B TATE MD PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437531837
- **Authorized official:** SUSAN TATE MD (OWNER)
- **Authorized official phone:** (502) 454-7871

## Contact information

- **Practice address:** 2934 BRECKENRIDGE LN STE 2, LOUISVILLE, KY 40220-3903
- **Practice address phone:** (502) 454-7871
- **Practice address fax:** (502) 454-7872
- **Mailing address:** 2934 BRECKENRIDGE LN STE 2, LOUISVILLE, KY 40220-3903
- **Mailing address phone:** (502) 454-7871
- **Mailing address fax:** (502) 454-7872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2015
- **Last updated:** 07/17/2015