Provider Demographics
NPI:1629131719
Name:LOUISVILLE NEUROLOGY ASSOCIATES PSC
Entity Type:Organization
Organization Name:LOUISVILLE NEUROLOGY ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:DAILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-589-6177
Mailing Address - Street 1:250 E LIBERTY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1530
Mailing Address - Country:US
Mailing Address - Phone:502-589-6177
Mailing Address - Fax:502-589-0544
Practice Address - Street 1:250 E LIBERTY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1530
Practice Address - Country:US
Practice Address - Phone:502-589-6177
Practice Address - Fax:502-589-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty