Organization
U OF L CHILDREN'S SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE C MCCOY (ACCOUNT COORDINATOR)
(502) 852-1297
Entity
Organization
Contact information
Practice address
501 E BROADWAY STE 280, LOUISVILLE, KY 40202-1785
(502) 852-1297
(502) 852-8556
Mailing address
234 E GRAY ST STE 568, LOUISVILLE, KY 40202-1914
(502) 852-1297
(502) 852-8556
Taxonomy
Speciality
Code
Description
License number
State
2080S0012X
Pediatric Sleep Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65933384
—
KY
Enumeration date
03/15/2007
Last updated
08/22/2020
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