Provider Demographics
NPI:1952341588
Name:BRIONES, VOLTAIRE CHAVEZ (MD)
Entity Type:Individual
Prefix:
First Name:VOLTAIRE
Middle Name:CHAVEZ
Last Name:BRIONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-361-1222
Mailing Address - Fax:502-368-1258
Practice Address - Street 1:1900 BLUEGRASS AVE STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1183
Practice Address - Country:US
Practice Address - Phone:502-361-1222
Practice Address - Fax:502-368-1258
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64176803Medicaid
KY64176803Medicaid
KYP00325997Medicare PIN
KY00546070Medicare Oscar/Certification