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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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