Organization
PEDIATRIC AND PERINATAL PATHOLOGY ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT F DEBSKI MD (LABORATORY MEDICAL DIRECTOR)
(502) 456-6212
Entity
Organization
Contact information
Practice address
231 E CHESTNUT ST, PATHOLOGY DEPT, LOUISVILLE, KY 40202-1821
(502) 456-6212
(502) 456-4440
Mailing address
1169 EASTERN PKWY, SUITE G71, LOUISVILLE, KY 40217-1417
(502) 456-6212
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
—
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
KY
207ZP0213X
Pediatric Pathology Physician
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059971
ANTHEM BLUE CROSS BS
KY
05
—
0112251
—
MI
05
—
100007320A
—
IN
01
—
1050363
PASSPORT MEDICAID
KY
01
—
1337243
UNITED MINE WORKERS
—
05
—
300039228A
—
GA
01
—
3503214
MEDICAID MONTANA
MT
05
—
4281797
—
TN
05
—
7100232480
—
KY
05
—
909288900
—
FL
01
—
DD1685
RAILROAD MEDICARE
—
Enumeration date
07/11/2006
Last updated
01/13/2017
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