Organization
BRECKENRIDGE MEDICAL GROUP, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY CARPENTER (OFFICE MANAGER)
(502) 909-3300
Entity
Organization
Contact information
Practice address
974 BRECKENRIDGE LN, SUITE 133, LOUISVILLE, KY 40207-4619
(502) 909-3300
Mailing address
974 BRECKENRIDGE LN, SUITE 133, LOUISVILLE, KY 40207-4619
(502) 909-3300
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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