1134174360 NPI number — UNIVERSITY OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PSC

Table of content: (NPI 1134174360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134174360 NPI number — UNIVERSITY OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134174360
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 S JACKSON ST
Provider Second Line Business Mailing Address:
UNIVERSITY OF LOUISVILLE DEPT. OF OB/GYN
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-5700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-271-5999
Provider Business Practice Location Address Fax Number:
502-271-5994
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COOK
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
LOUISE
Authorized Official Title or Position:
PROFESSOR AND CHAIR
Authorized Official Telephone Number:
502-271-5999

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LW0102X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1049267 . This is a "PASSPORT SPECIALTY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000057500 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 65900631 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100033630 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100023320 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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