Organization
FAMILY CARE PHYSICIANS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA D JESSE (OFFICE MANAGER)
(502) 243-8481
Entity
Organization
Contact information
Practice address
2701 CHAMBERLAIN LN, LOUISVILLE, KY 40245-1603
(502) 243-8481
Mailing address
2701 CHAMBERLAIN LN, LOUISVILLE, KY 40245-1603
(502) 243-8481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063576601
NPI
KY
05
—
65934697
—
KY
01
—
DD1879
RAILROAD MEDICARE
KY
Enumeration date
12/20/2006
Last updated
12/19/2019
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