Provider Demographics
NPI:1245525013
Name:KENTUCKY URGENT CARE, PLLC
Entity type:Organization
Organization Name:KENTUCKY URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-238-9911
Mailing Address - Street 1:720 W BROADWAY
Mailing Address - Street 2:202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2240
Mailing Address - Country:US
Mailing Address - Phone:502-238-9911
Mailing Address - Fax:502-238-9912
Practice Address - Street 1:329 FLOYD DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008
Practice Address - Country:US
Practice Address - Phone:502-238-9911
Practice Address - Fax:502-238-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty