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Organization

UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION

Active
Other names
UofL Family Medicine @ ACB
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES G. O'BRIEN MD (DEPARTMENT CHAIRMAN)
(502) 852-8498
Entity
Organization

Contact information

Practice address
550 S JACKSON ST, 1ST FLOOR, LOUISVILLE, KY 40202-1622
(502) 562-6503
(502) 562-6504
Mailing address
501 E BROADWAY, STE 290, LOUISVILLE, KY 40202-1785
(502) 217-5134
(502) 217-5056

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1120262
PASSPORT HEALTH PLAN
KY
05
7100091550
KY
05
7100108960 (ARNPS)
KY
Enumeration date
04/24/2006
Last updated
07/07/2010
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