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Pediatric Gastroenterology Psc
Clinic/Center in Louisville, Kentucky
NPI 1164455952

Pediatric Gastroenterology Psc is a Clinic/Center based in Louisville, KY. Pediatric Gastroenterology Psc practices in Louisville, KY. The NPI Number for Pediatric Gastroenterology Psc is 1164455952 and holds a License No. 0424168 (Kentucky).

The current practice location address for Pediatric Gastroenterology Psc is 233 E Gray St, Louisville, KY and can be reached out via phone at 502-629-5796 and via fax at 502-629-5799.

Location: 233 E Gray St, Louisville, KY, 40202-2026
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164455952
Provider Name
Pediatric Gastroenterology Psc
Credential
Provider Entity Type
Organization
Address
233 E Gray St, Louisville, KY, 40202-2026
Phone Number
502-629-5796
Fax Number
502-629-5799
Provider Enumeration Date
07/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1049092 01 KY PASSPORT GROUP NUMBER
200140610A 05 IN
65927816 05 KY
institution
Provider Business Practice Location Address Details
Address
233 E Gray St
City
Louisville
State
Kentucky
Zip
40202-2026
Phone Number
502-629-5796
Fax Number
502-629-5799
person
Provider Business Mailing Address Details
Address
233 E Gray St
City
Louisville
State
Kentucky
Zip
40202-2026
Phone Number
502-629-5796
Fax Number
502-629-5799
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
0424168 (Kentucky)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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