Provider Demographics
NPI:1346544905
Name:BAPTIST MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:BAPTIST MEDICAL ASSOCIATES
Other - Org Name:BHN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-238-2801
Mailing Address - Street 1:2600 STANLEY GAULT PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4197
Mailing Address - Country:US
Mailing Address - Phone:502-238-2801
Mailing Address - Fax:
Practice Address - Street 1:2600 STANLEY GAULT PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4197
Practice Address - Country:US
Practice Address - Phone:502-238-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00162Medicare PIN