Provider Demographics
NPI:1710309794
Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Entity Type:Organization
Organization Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Other - Org Name:ULRF INTERNATIONAL ADOPTION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP OF HEALTH AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-852-5184
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0320
Mailing Address - Fax:502-588-0326
Practice Address - Street 1:571 S FLOYD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3818
Practice Address - Country:US
Practice Address - Phone:502-629-2398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF LOUISVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65908238Medicaid