# ALL-STAR PEDIATRICS PSC

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

## Provider details

- **NPI number:** 1689774994
- **Authorized official:** MS. JEAN L GEE (OFFICE MANAGER)
- **Authorized official phone:** (502) 762-0498

## Contact information

- **Practice address:** 6425 BARDSTOWN RD, LOUISVILLE, KY 40291-3040
- **Practice address phone:** (502) 762-0498
- **Practice address fax:** (502) 762-0469
- **Mailing address:** 6425 BARDSTOWN RD, LOUISVILLE, KY 40291-3040
- **Mailing address phone:** (502) 762-0498
- **Mailing address fax:** (502) 762-0469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 27333 | KY | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 37862 | KY | — |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 06/30/2008