Provider Demographics
NPI:1679626147
Name:ORTHOPAEDIC ASSOCIATES
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:O
Authorized Official - Last Name:BONNARENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-585-4376
Mailing Address - Street 1:225 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1846
Mailing Address - Country:US
Mailing Address - Phone:502-585-4376
Mailing Address - Fax:502-581-1274
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:STE 403
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1846
Practice Address - Country:US
Practice Address - Phone:502-585-4376
Practice Address - Fax:502-581-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29483207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCB5792OtherRAILROAD MEDICARE
KY0285OtherANTHEM GROUP ID NUMBER
KY0334580001OtherDMERC
KY0334580001OtherDMERC
KY=========OtherTAX ID# FOR GROUP