Organization
SOUTHERN EMERGENCY MEDICAL SPECIALISTS, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE A OSBORNE CPMSM, CPCS (CREDENTIALING MANAGER)
(502) 634-6767
Entity
Organization
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 634-6767
(502) 634-6775
Mailing address
PO BOX 36218, LOUISVILLE, KY 40233-6218
(502) 634-6767
(502) 634-6775
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059434
ANTHEM
KY
01
—
1049497
PASSPORT
KY
05
—
200350210A
—
IN
01
—
2432546000
PASSPORT ADVANTAGE
KY
05
—
65912347
—
KY
05
—
7100046860
—
KY
05
—
78901741
—
KY
Enumeration date
01/11/2006
Last updated
07/06/2022
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