Organization
INTERNAL MEDICINE CONSULTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN G POLO M.D. (PHYSICIAN)
(502) 629-4525
Entity
Organization
Contact information
Practice address
234 E GRAY ST STE 670, LOUISVILLE, KY 40202-1901
(502) 629-4525
(502) 629-4529
Mailing address
234 E GRAY ST STE 670, LOUISVILLE, KY 40202-1901
(502) 629-4525
(502) 629-4529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36067
KY
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
3006356
KY
363LF0000X
Family Nurse Practitioner
3008115
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1128116
PAAAPORT
KY
Enumeration date
10/02/2008
Last updated
06/16/2014
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