Organization
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Active
Other names
UofL Family Medicine at Cardinal Station
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES OBRIEN MD (CHARIMAN OF DEPARTMENT)
(502) 852-5498
Entity
Organization
Contact information
Practice address
215 CENTRAL AVE, 100, LOUISVILLE, KY 40208-1449
(502) 852-2822
(502) 852-2819
Mailing address
501 E BROADWAY, SUITE 290, LOUISVILLE, KY 40202-1785
(502) 217-8221
(502) 217-5056
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051450
PASSPORT HEALTH PLAN
KY
05
—
200255880 A
—
IN
05
—
65900474
—
KY
05
—
78905379 -APRN
—
KY
Enumeration date
04/25/2006
Last updated
10/31/2011
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