Provider Demographics
NPI:1093057762
Name:GEORGE C STEGE III DBA HURSTBOURNE FAMILY CARE
Entity Type:Organization
Organization Name:GEORGE C STEGE III DBA HURSTBOURNE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEGE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:502-583-3189
Mailing Address - Street 1:2304 HURSTBOURNE VILLAGE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1886
Mailing Address - Country:US
Mailing Address - Phone:502-583-3189
Mailing Address - Fax:502-581-1463
Practice Address - Street 1:2304 HURSTBOURNE VILLAGE DR STE 500
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1886
Practice Address - Country:US
Practice Address - Phone:502-583-3189
Practice Address - Fax:502-581-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty