Organization
COMMONWEALTH INFECTIOUS DISEASE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC XIA M.D. (PRESIDENT)
(812) 948-5159
Entity
Organization
Contact information
Practice address
3910 S DUPONT SQ, SUITE A, LOUISVILLE, KY 40207-4615
(502) 896-8299
Mailing address
PO BOX 32172, LOUISVILLE, KY 40232-2172
(502) 896-8299
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
33270
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65905838
—
KY
Enumeration date
04/03/2006
Last updated
07/01/2020
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