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Organization

LOUISVILLE ALLERGY & ASTHMA, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID PALLARES M.D. (PRESIDENT)
(502) 363-8624
Entity
Organization

Contact information

Practice address
4402 CHURCHMAN AVE, SUITE 401, LOUISVILLE, KY 40215-1190
(502) 363-8624
(502) 363-7059
Mailing address
4402 CHURCHMAN AVE, SUITE 401, LOUISVILLE, KY 40215-1190
(502) 363-8624
(502) 363-7059

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
27337
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1068611
PASSPORT
KY
05
7100291360
KY
Enumeration date
12/11/2006
Last updated
07/23/2014
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