Provider Demographics
NPI:1700886637
Name:EDWARD C ADLER AND ASSOCIATES
Entity Type:Organization
Organization Name:EDWARD C ADLER AND ASSOCIATES
Other - Org Name:GASTROENTEROLOGY CONSULTANTS OF LOUISVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-896-4711
Mailing Address - Street 1:4001 DUTCHMANS LN
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4714
Mailing Address - Country:US
Mailing Address - Phone:502-896-4711
Mailing Address - Fax:502-896-4791
Practice Address - Street 1:4001 DUTCHMANS LN
Practice Address - Street 2:SUITE 7B
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4714
Practice Address - Country:US
Practice Address - Phone:502-896-4711
Practice Address - Fax:502-896-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000355586OtherANTHEM PIN #
KY64216492Medicaid
KY7100085090Medicaid
KY000000049919OtherANTHEM PIN #
KY00000023668OtherANTHEM PIN #
KY64291388Medicaid
KY64321516Medicaid
KY000000049918OtherANTHEM PIN #
KY64095938Medicaid
KY64049711Medicaid
KY000000049917OtherANTHEM PIN #
KY000000049917OtherANTHEM PIN #
KY000000049919OtherANTHEM PIN #
KYF78714Medicare UPIN
KY000000049918OtherANTHEM PIN #
KY253903Medicare ID - Type Unspecified
KY7100085090Medicaid
KY64291388Medicaid
KY64216492Medicaid