Organization
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Active
Other names
U of L Family Medicine at Newburg
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES OBRIEN MD (CHAIRMAN OF DEPARTMENT)
(502) 852-5498
Entity
Organization
Contact information
Practice address
1941 BISHOP LN STE 900, LOUISVILLE, KY 40218-1922
(502) 852-6684
(502) 852-5698
Mailing address
501 E BROADWAY, SUITE 290, LOUISVILLE, KY 40202-1785
(502) 217-8221
(502) 217-5056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051451
PASSPORT HEALTH PLAN
KY
05
—
200255880 C
—
IN
05
—
65900227
—
KY
05
—
78905395 (ARNPS)
—
KY
Enumeration date
04/21/2006
Last updated
10/08/2010
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