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Organization
PROACTIVE MD KY PSC
Active
Organization
PROACTIVE MD KY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALLEN KEMBLE MD (CHIEF MEDICAL OFFICER)
(864) 640-8355
Entity
Organization
Contact information
Practice address
4340 CRITTENDEN DR, LOUISVILLE, KY 40209-1600
(864) 501-0751
Mailing address
86 VILLA RD STE 100, GREENVILLE, SC 29615-3052
(864) 640-8355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
08/31/2026
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