Provider Demographics
NPI:1073765756
Name:VERSAILLES INTERNAL MEDICINE, PLC
Entity Type:Organization
Organization Name:VERSAILLES INTERNAL MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOFFSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-873-0511
Mailing Address - Street 1:370 AMSDEN AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9320
Mailing Address - Country:US
Mailing Address - Phone:859-873-0511
Mailing Address - Fax:859-873-0523
Practice Address - Street 1:370 AMSDEN AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-9320
Practice Address - Country:US
Practice Address - Phone:859-873-0511
Practice Address - Fax:859-873-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32192207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty