Provider Demographics
NPI:1336133867
Name:DRS SHPILBERG & SHPILBERG LLP
Entity Type:Organization
Organization Name:DRS SHPILBERG & SHPILBERG LLP
Other - Org Name:PLEASURE RIDGE PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHPILBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-937-3154
Mailing Address - Street 1:8033 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-1344
Mailing Address - Country:US
Mailing Address - Phone:502-937-3154
Mailing Address - Fax:502-935-0743
Practice Address - Street 1:8033 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-1344
Practice Address - Country:US
Practice Address - Phone:502-937-3154
Practice Address - Fax:502-935-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65937591Medicaid
KYCI1648Medicare PIN
KY0073Medicare PIN