Organization
KOMG-LOUISVILLE REGION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD E. WALDRIDGE II MD (DIRECTOR)
(502) 259-6010
Entity
Organization
Contact information
Practice address
201 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-3841
(502) 259-6010
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 259-6010
(502) 540-3393
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/12/2018
Last updated
11/13/2018
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