Organization
CLEANSLATE MEDICAL GROUP OF KENTUCKY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW PHILIP SMOLAREK (CFO)
(412) 999-5188
Entity
Organization
Contact information
Practice address
6801 DIXIE HWY STE 132, LOUISVILLE, KY 40258-3952
(502) 657-2701
(833) 279-7074
Mailing address
8 CADILLAC DR STE 300, BRENTWOOD, TN 37027-5337
(154) 250-0220
(833) 279-7074
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
12/17/2025
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