Organization
CARDIAC CARE CENTER OF LOUISVILLE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE E ADAMS III M.D. (OWNER)
(502) 585-4321
Entity
Organization
Contact information
Practice address
400 EXECUTIVE PARK, LOUISVILLE, KY 40207-4204
(502) 585-4321
(502) 895-6083
Mailing address
PO BOX 457, LOUISVILLE, KY 40201-0457
(502) 585-4321
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1116099
—
KY
05
—
2436919000
—
KY
05
—
65901324
—
KY
05
—
78902657
—
KY
05
—
95900494
—
KY
Enumeration date
05/22/2007
Last updated
11/12/2007
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