Organization
LOUISVILLE WOUND CARE ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY D MCMILLIN MD (PRESIDENT)
(502) 777-9961
Entity
Organization
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217
(502) 777-9961
(502) 379-8791
Mailing address
2100 GARDINER LN STE 207, LOUISVILLE, KY 40205-2948
(502) 777-9961
(502) 379-8791
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
23946
KY
208600000X
Surgery Physician
Primary
18435
KY
363L00000X
Nurse Practitioner
3003616
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486840
ANTHEM
KY
05
—
201260300
—
IN
01
—
50012570
PASSPORT
KY
05
—
65945933
—
KY
05
—
78905221
—
KY
Enumeration date
08/07/2006
Last updated
05/16/2018
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