1700886637 NPI number — EDWARD C ADLER AND ASSOCIATES

Table of content: (NPI 1700886637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700886637 NPI number — EDWARD C ADLER AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDWARD C ADLER AND ASSOCIATES
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:
GASTROENTEROLOGY CONSULTANTS OF LOUISVILLE
Provider Other Organization Name Type Code:
3
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:
1700886637
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4001 DUTCHMANS LN
Provider Second Line Business Mailing Address:
SUITE 7B
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40207-4714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-896-4711
Provider Business Mailing Address Fax Number:
502-896-4791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4001 DUTCHMANS LN
Provider Second Line Business Practice Location Address:
SUITE 7B
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207-4714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-896-4711
Provider Business Practice Location Address Fax Number:
502-896-4791
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ADLER
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICAIN
Authorized Official Telephone Number:
502-896-4711

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000355586 . This is a "ANTHEM PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64216492 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100085090 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000049919 . This is a "ANTHEM PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00000023668 . This is a "ANTHEM PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64291388 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64321516 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000049918 . This is a "ANTHEM PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64095938 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64049711 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000049917 . This is a "ANTHEM PIN #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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