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Organization

BULLITT COUNTY FAMILY CARE CENTER, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLOTTE KAY INGWERSEN MD (PRESIDENT)
(502) 955-5200
Entity
Organization

Contact information

Practice address
1578 HIGHWAY 44 EAST, SUITE 2, SHEPHERDSVILLE, KY 40165
(502) 955-5200
(502) 543-5244
Mailing address
P.O. BOX 1069, SHEPHERDSVILLE, KY 40165
(502) 955-5200
(502) 543-5244

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
32033
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64320336
KY
Enumeration date
06/14/2006
Last updated
11/20/2013
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