Provider Demographics
NPI:1396726675
Name:TASCH, BRUCE J (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:J
Last Name:TASCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6000 BROWNSBORO PARK BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-7201
Mailing Address - Country:US
Mailing Address - Phone:502-899-9560
Mailing Address - Fax:502-899-9561
Practice Address - Street 1:6000 BROWNSBORO PARK BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-7201
Practice Address - Country:US
Practice Address - Phone:502-899-9560
Practice Address - Fax:502-899-9561
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2014-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY223052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1411301Medicare ID - Type Unspecified
KYC75429Medicare UPIN