Provider Demographics
NPI:1578988671
Name:GEORGE C STEGE III
Entity Type:Organization
Organization Name:GEORGE C STEGE III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-584-1061
Mailing Address - Street 1:2304 HURSTBOURNE VILLAGE DR
Mailing Address - Street 2:STE 500
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2304 HURSTBOURNE VILLAGE DR
Practice Address - Street 2:STE 500
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1853
Practice Address - Country:US
Practice Address - Phone:502-583-3189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty