Provider Demographics
NPI:1164442604
Name:LOUISVILLE ENDOCRINE CONSULTANTS, PSC
Entity Type:Organization
Organization Name:LOUISVILLE ENDOCRINE CONSULTANTS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARNES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:502-238-9911
Mailing Address - Street 1:720 W. BROADWAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3245
Mailing Address - Country:US
Mailing Address - Phone:502-238-9911
Mailing Address - Fax:502-238-9912
Practice Address - Street 1:1900 BLUEGRASS AVENUE
Practice Address - Street 2:SUITE 108
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1144
Practice Address - Country:US
Practice Address - Phone:502-361-2524
Practice Address - Fax:502-361-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65944753Medicaid
IN200854640Medicaid
KYDF0202OtherRAILROAD MEDICARE KY
IN200854640Medicaid