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Organization

AMIN'S FAMILY PRACTICE ASSOCIATES , PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAJAN R AMIN M.D. (PRESIDENT)
(502) 637-1005
Entity
Organization

Contact information

Practice address
1505 S 7TH ST, LOUISVILLE, KY 40208-1710
(502) 637-1005
(502) 635-0046
Mailing address
1505 S 7TH ST, LOUISVILLE, KY 40208-1710
(502) 637-1005
(502) 635-0046

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
19340
KY
208D00000X
General Practice Physician
363LA2100X
Acute Care Nurse Practitioner
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1050005
PASSPORT HEALTH PLAN
KY
01
1050006
PASSPORT HEALTH PLAN
KY
01
1050007
PASSPORT HEALTH PLAN
KY
01
2432747001
PASSPORT ADVANTAGE
KY
01
2432748001
PASSPORT ADVANTAGE
KY
01
2432749001
PASSPORT ADVANTAGE
KY
05
65911745
KY
Enumeration date
07/15/2006
Last updated
05/02/2014
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