Provider Demographics
NPI:1477187920
Name:ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC
Entity Type:Organization
Organization Name:ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-587-1236
Mailing Address - Street 1:5120 DIXIE HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-1775
Mailing Address - Country:US
Mailing Address - Phone:502-587-1236
Mailing Address - Fax:
Practice Address - Street 1:6768 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3048
Practice Address - Country:US
Practice Address - Phone:502-587-1236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty