Organization
TYSON, SCHWAB, SHORT & WEISS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN LESLIE M.D. (PRESIDENT/RADIOLOGIST)
(502) 583-2731
Entity
Organization
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-1818
(502) 587-4231
Mailing address
222 S 1ST ST, SUITE 501, LOUISVILLE, KY 40202-5404
(502) 583-2731
(502) 583-2733
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000063366
ANTHEM BLUE FACET
KY
05
—
078680801
—
TX
05
—
100001620A
—
IN
05
—
100001620B
—
IN
05
—
100001620C
—
IN
05
—
100001620E
—
IN
05
—
1058376
—
KY
05
—
2145128
—
OH
05
—
3810004746
—
WV
05
—
529925200
—
AL
05
—
65901985
—
KY
01
—
CD0227
RAILROAD MEDICARE
KY
Enumeration date
05/09/2006
Last updated
03/12/2018
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