Organization
BEARGRASS MEDICAL ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY JAMES WALTER MD (PRESIDENT)
(502) 456-3990
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY, STE 1234, LOUISVILLE, KY 40217-1462
(502) 456-3990
(502) 456-3988
Mailing address
1169 EASTERN PKWY, STE 1234, LOUISVILLE, KY 40217-1462
(502) 456-3990
(502) 456-3988
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17516
—
207R00000X
Internal Medicine Physician
Primary
215554
—
Other
Enumeration date
10/02/2006
Last updated
03/12/2010
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