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Organization

LOUISVILLE PM&R PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN L SWINT MD (OWNER)
(502) 472-7089
Entity
Organization

Contact information

Practice address
4120 WOODED ACRE LN, LOUISVILLE, KY 40245-2938
(502) 963-1905
Mailing address
PO BOX 22306, LOUISVILLE, KY 40252-0306
(502) 963-1905

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000991965
ANTHEM
KY
01
50103348
PASSPORT HEALTH PLAN
KY
05
7100397810
KY
01
DW2736
RAILROAD MEDICARE
KY
Enumeration date
01/07/2016
Last updated
12/07/2021
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