# JEFFERSOTOWN FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1689788853
- **Authorized official:** MS. SUE C ENGLEMAN O (BUSINESS MANGER)
- **Authorized official phone:** (502) 267-5456

## Contact information

- **Practice address:** 10216 TAYLORSVILLE RD, SUITE\#400, LOUISVILLE, KY 40299-3616
- **Practice address phone:** (502) 267-5456
- **Practice address fax:** (502) 240-5610
- **Mailing address:** 10216 TAYLORSVILLE RD, SUITE\#400, LOUISVILLE, KY 40299-3616
- **Mailing address phone:** (502) 267-5456
- **Mailing address fax:** (502) 240-5610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 12/02/2008