Organization
UFPA CENTER FOR PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES G. O'BRIEN MD (PRESIDENT/DEPARTMENT CHAIR)
(502) 852-8498
Entity
Organization
Contact information
Practice address
215 CENTRAL AVE, STE 205, LOUISVILLE, KY 40208-1449
(502) 852-3322
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 852-5205
(500) 285-2540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200940330
—
IN
01
—
3704175000
PASSPORT ADV
KY
01
—
50023132
PASSPORT
KY
05
—
7100083770
—
KY
Enumeration date
11/10/2008
Last updated
10/18/2012
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