Provider Demographics
NPI:1083613194
Name:LOUISVILLE INPATIENT PHYSICIAN SERVICES, PLLC
Entity Type:Organization
Organization Name:LOUISVILLE INPATIENT PHYSICIAN SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AFTAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-929-3034
Mailing Address - Street 1:PO BOX 950113, DEPT# 52398
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295
Mailing Address - Country:US
Mailing Address - Phone:630-929-3034
Mailing Address - Fax:502-585-2831
Practice Address - Street 1:4007 WHITEBLOSSOM ESTATES CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4182
Practice Address - Country:US
Practice Address - Phone:630-929-3034
Practice Address - Fax:502-585-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65938250Medicaid
KYCK2474OtherRAILROAD MEDICARE KY
INDF0459OtherRAILROAD MEDICARE IND
IN200406970 A-EMedicaid
IN232600Medicare PIN
IN200406970 A-EMedicaid