Organization
SOUTH OLDHAM MEDICAL CLINIC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOR ALUR MD (PHYSICIAN OWNER)
(502) 241-8488
Entity
Organization
Contact information
Practice address
6520 W HWY 22, CRESTWOOD, KY 40014
(502) 241-8488
(502) 241-7424
Mailing address
6520 W HWY 22, CRESTWOOD, KY 40014
(502) 241-8488
(502) 241-7424
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
30373
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64303738
—
KY
Enumeration date
02/16/2007
Last updated
08/22/2020
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