Individual
PHILLIP BRESSOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST, STE 110, LOUISVILLE, KY 40202-5700
(502) 852-6446
(502) 852-6649
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27304
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200034910
—
IN
01
—
3539034000
PASSPORT ADVANTAGE
KY
01
—
50020532
PASSPORT
KY
05
—
64273048
—
KY
Enumeration date
12/20/2005
Last updated
07/01/2015
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