# KOMG-LOUISVILLE REGION INC.

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

## Provider details

- **NPI number:** 1952870479
- **Authorized official:** RONALD E. WALDRIDGE MD (PRESIDENT/PHYSICIAN EXECUTIVE)
- **Authorized official phone:** (502) 210-6010

## Contact information

- **Practice address:** 201 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-3841
- **Practice address phone:** (502) 259-6010
- **Mailing address:** 100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
- **Mailing address phone:** (502) 540-3339
- **Mailing address fax:** (502) 540-3393

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 2081H0002X | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081H0002X | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/14/2018
- **Last updated:** 01/30/2019