Provider Demographics
NPI:1861450280
Name:VON BUN, ELISABETH C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:C
Last Name:VON BUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1703
Mailing Address - Country:US
Mailing Address - Phone:502-629-2500
Mailing Address - Fax:502-629-3166
Practice Address - Street 1:301 GORDON GUTMANN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3764
Practice Address - Country:US
Practice Address - Phone:812-288-9969
Practice Address - Fax:812-288-9657
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32167207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6698103OtherCIGNA PROVIDER NUMB
KY200085120Medicaid
KY5158197OtherAETNA PROVIDER NUMB
KY000054971BOtherHUMANA PROVIDER NUMB
KY50007896OtherPASSPORT PROVIDER NUMB
KYP00421372OtherRAILROAD MEDICARE
KY000000365365OtherANTHEM PROVIDER NUMB
KY64360589Medicaid
INP00199433OtherRAILROAD MEDICARE
KYP00421372OtherRAILROAD MEDICARE
KY000000365365OtherANTHEM PROVIDER NUMB
INP00199433OtherRAILROAD MEDICARE
KY0299021Medicare PIN