Organization
PROMPTCARE PHYSICIAN GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA LYNN SHANKS (MANGER)
(502) 412-1112
Entity
Organization
Contact information
Practice address
3215 WESTPORT GREEN PL, LOUISVILLE, KY 40241-3135
(502) 412-1112
(502) 357-0606
Mailing address
3215 WESTPORT GREEN PL, LOUISVILLE, KY 40241-3135
(502) 412-1112
(502) 357-0606
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000061352
ANTHEM BSBS
KY
Enumeration date
07/23/2006
Last updated
08/22/2020
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