Organization
LOUISVILLE FAMILY & SPORTS MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY V POTTS M.D. (PRESIDENT)
(502) 426-4264
Entity
Organization
Contact information
Practice address
9420 BROWNSBORO RD, LOUISVILLE, KY 40241-1118
(502) 426-4264
(402) 426-4221
Mailing address
9420 BROWNSBORO RD, LOUISVILLE, KY 40241-1118
(502) 426-4264
(502) 426-4221
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052203
ANTHEM BCBS-GP
KY
01
—
000000052204
ANTHEM BCBS-CP
KY
01
—
000000346469
ANTHM BCBS-ST
KY
05
—
6593237800
—
KY
Enumeration date
06/06/2006
Last updated
03/28/2011
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