Provider Demographics
NPI:1174504955
Name:DRS HURST & MARQUESS PSC
Entity Type:Organization
Organization Name:DRS HURST & MARQUESS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARQUESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-584-6173
Mailing Address - Street 1:801 BARRET AVE
Mailing Address - Street 2:STE 316
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1747
Mailing Address - Country:US
Mailing Address - Phone:502-584-6173
Mailing Address - Fax:502-584-6175
Practice Address - Street 1:801 BARRET AVE
Practice Address - Street 2:STE 316
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1747
Practice Address - Country:US
Practice Address - Phone:502-584-6173
Practice Address - Fax:502-584-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2822Medicare PIN