Organization
KENTUCKIANA EMERGENCY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D BISHOP MD (CEO)
(877) 889-3383
Entity
Organization
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 636-7111
Mailing address
PO BOX 4778, BLOOMINGTON, IN 47402-4778
(812) 336-1690
(812) 349-1311
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
207PS0010X
Sports Medicine (Emergency Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200226910
—
IN
05
—
65909244
—
KY
05
—
65931719
—
KY
05
—
65931727
—
KY
05
—
65932972
—
KY
05
—
78905262
—
KY
Enumeration date
06/02/2006
Last updated
03/25/2010
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