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Organization

MICHAEL ALT DO PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL ALT (OWNER)
(502) 897-5997
Entity
Organization

Contact information

Practice address
2934 BRECKENRIDGE LN STE 2, LOUISVILLE, KY 40220-3903
(502) 454-7871
(502) 454-7872
Mailing address
2934 BRECKENRIDGE LN STE 2, LOUISVILLE, KY 40220-3903
(502) 454-7871
(502) 454-7872

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50018842
PASSPORT
KY
05
64022452
KY
Enumeration date
04/16/2008
Last updated
04/17/2014
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