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Organization

UNIVERSITY ORTHOPAEDIC DEPARTMENTAL ENTITY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRAIG ROBERTS MD (DIRECTOR)
(502) 852-5319
Entity
Organization

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5319
(502) 852-7227
Mailing address
550 S JACKSON ST, ACB FIRST FLOOR, LOUISVILLE, KY 40202-1622
(502) 852-5319
(502) 852-7227

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
27747
KY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
40767
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
27746
KY
207XX0801X
Orthopaedic Trauma Physician
40767
KY

Other

Enumeration date
05/14/2012
Last updated
08/03/2012
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