Organization
LOUISVILLE ENDOSCOPY CENTER, PLLC
Active
Other names
Louisville Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1400 POPLAR LEVEL RD, SUITE 2, LOUISVILLE, KY 40217-1309
(502) 636-2003
(502) 636-4032
Mailing address
1A BURTON HILLS BLVD, ATTN: L&C, NASHVILLE, TN 37215-6103
(615) 665-1283
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300132
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200411570A
—
IN
01
—
2437243000
PASSPORT ADVANTAGE
KY
05
—
2437243000
—
KY
05
—
36001055
—
KY
Enumeration date
02/07/2006
Last updated
04/22/2022
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