Individual
DR. MARCO CORNELIS LOUISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42180
KY
207Q00000X
Family Medicine Physician
MD00041159
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000590540
ANTHEM
KY
05
—
201000050
—
IN
05
—
7100270690
—
KY
05
—
8313868
—
WA
01
—
P00378656
RAILROAD MEDICARE
WA
01
—
P00737020
RAILROAD MEDICARE
IN
01
—
P00817257
RAILROAD MEDICARE
KY
Enumeration date
08/01/2006
Last updated
03/06/2023
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