Organization
UNIVERSITY FAMILY PRACTICE ASSOC. PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES O'BRIEN (DEPARTMENT CHAIRMAN)
(502) 852-8498
Entity
Organization
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202
(502) 562-6503
Mailing address
501 E BROADWAY, STE 290, LOUISVILLE, KY 40202-1785
(502) 217-5134
(502) 217-5137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65905960
—
KY
Enumeration date
05/30/2006
Last updated
04/04/2008
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