1770534232 NPI number — WILLIAM A. HYMES M.D.

Table of content: EVA IRENE BORBONUS (NPI 1427846450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770534232 NPI number — WILLIAM A. HYMES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HYMES
Provider First Name:
WILLIAM
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1770534232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 ABRAHAM FLEXNER WAY
Provider Second Line Business Mailing Address:
SUITE 1200
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-3849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-583-8383
Provider Business Mailing Address Fax Number:
502-583-8389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 ABRAHAM FLEXNER WAY
Provider Second Line Business Practice Location Address:
SUITE 1200
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-3849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-583-8383
Provider Business Practice Location Address Fax Number:
502-583-8389
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  29525 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000389899 . This is a "ANTHEM BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 4358296 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2690385000 . This is a "PASSPORT ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64295256 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0585991 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50009809 . This is a "PASSPORT" identifier . This identifiers is of the category "OTHER".




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