Provider Demographics
NPI:1780372508
Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC.
Entity type:Organization
Organization Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP OF HEATH AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-588-0320
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:
Practice Address - Street 1:9616 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272
Practice Address - Country:US
Practice Address - Phone:502-588-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty