Provider Demographics
NPI:1174819106
Name:NORTON HOSPITALS INC
Entity Type:Organization
Organization Name:NORTON HOSPITALS INC
Other - Org Name:NORTON CARDIOVASCULAR DIAGNOSTIC CENTER- DIXIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-629-8326
Mailing Address - Street 1:PO BOX 35070
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-5070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4420 DIXIE HWY
Practice Address - Street 2:STE 120
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2988
Practice Address - Country:US
Practice Address - Phone:502-629-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON HOSPITALS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01012764Medicaid
180088Medicare Oscar/Certification