Provider Demographics
NPI:1568732097
Name:UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.
Other - Org Name:ULP COLORECTAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-561-2404
Mailing Address - Street 1:501 E BROADWAY STE 290
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2040
Mailing Address - Country:US
Mailing Address - Phone:502-217-5134
Mailing Address - Fax:502-217-5056
Practice Address - Street 1:401 E CHESTNUT ST UNIT 710
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5707
Practice Address - Country:US
Practice Address - Phone:502-583-8303
Practice Address - Fax:502-583-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty