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Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's Allergy and Immunology
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY GAST (SYST VP OF MNGD CARE & PAYOR STRAT)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 588-9490
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5336
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
10/04/2019
Last updated
09/22/2021
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