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Organization

NORTON CHILDREN'S MEDICAL GROUP, LLC

Active
Other names
Norton Children's Hematology and Oncology
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHELLEY GAST (SYST VP MNGD CARE AND PAYOR STRAT)
(502) 272-5335
Entity
Organization

Contact information

Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 272-5336
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5336
(502) 272-5339

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
208000000X
Pediatrics Physician
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner

Other

Enumeration date
10/04/2019
Last updated
09/22/2021
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