Organization
GREGORY B. NAZAR, M.D., PSC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAWN R PATE (OFFICE MANAGER)
(502) 636-2667
Entity
Organization
Contact information
Practice address
3 AUDUBON PLAZA DR, SUITE 410, LOUISVILLE, KY 40217-1300
(502) 636-2667
(502) 636-2668
Mailing address
3 AUDUBON PLAZA DR, SUITE 410, LOUISVILLE, KY 40217-1300
(502) 636-2667
(502) 636-2668
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
26253
KY
363L00000X
Nurse Practitioner
3003327
KY
363L00000X
Nurse Practitioner
3006765
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50023701
PASSPORT GROUP
KY
05
—
7100198630 MDGRP
—
KY
05
—
7100204780 NPGRP
—
KY
Enumeration date
08/20/2006
Last updated
08/09/2012
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