Provider Demographics
NPI:1114919834
Name:PARADOWSKI, BRIAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:PARADOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-585-1200
Mailing Address - Fax:502-585-1207
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 304
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1846
Practice Address - Country:US
Practice Address - Phone:502-585-1200
Practice Address - Fax:502-585-1207
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051844OtherANTHEM
KY110170685OtherRAILROAD MEDICARE
KY200110020AOtherINDIANA MEDICAID
KY64327968Medicaid
KY1049366OtherPASSPORT
KY200110020AOtherINDIANA MEDICAID
KY000000051844OtherANTHEM
KYG37077Medicare UPIN
KY0523501Medicare ID - Type Unspecified