Organization
UROGYNECOLOGY CONSULTANTS PLLC
Active
Organization
UROGYNECOLOGY CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A GRAHAM M.D. (OFFICE MANAGER)
(502) 409-5600
Entity
Organization
Contact information
Practice address
4121 DUTCHMANS LN, STE 307, LOUISVILLE, KY 40207-4707
(502) 409-5600
(502) 409-5606
Mailing address
PO BOX 950136, LOUISVILLE, KY 40295-0136
(502) 429-8505
(502) 429-8547
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
36345
KY
208800000X
Urology Physician
36345
KY
363L00000X
Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000666770
ANTHEM
KY
Enumeration date
05/12/2010
Last updated
11/04/2010
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