Provider Demographics
NPI:1689280216
Name:HMPS INTERNAL MEDICINE OF WEST LOUISVILLE PLLC
Entity Type:Organization
Organization Name:HMPS INTERNAL MEDICINE OF WEST LOUISVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:502-548-7791
Mailing Address - Street 1:927 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2621
Mailing Address - Country:US
Mailing Address - Phone:502-618-4298
Mailing Address - Fax:
Practice Address - Street 1:927 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2621
Practice Address - Country:US
Practice Address - Phone:502-618-4298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty