Organization
COMMUNITY MEDICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (VP MANAGED CARE)
(502) 588-9490
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 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65928301
—
KY
05
—
78901329
—
KY
01
—
9999
DBA NORTON OCCUPATIONAL MEDICINE
KY
Enumeration date
02/19/2015
Last updated
09/21/2021
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