Provider Demographics
NPI:1659725331
Name:UNIVERSITY OF LOUISVILLE OB/GYN
Entity Type:Organization
Organization Name:UNIVERSITY OF LOUISVILLE OB/GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OBGYN RESIDENCY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:THEORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-561-7448
Mailing Address - Street 1:550 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1622
Mailing Address - Country:US
Mailing Address - Phone:502-561-7448
Mailing Address - Fax:502-561-7480
Practice Address - Street 1:550 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1622
Practice Address - Country:US
Practice Address - Phone:502-561-7448
Practice Address - Fax:502-561-7480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF LOUISVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital