Provider Demographics
NPI:1952778151
Name:DR. PADMAPRIYA BALAKRISHNA M. D.
Entity Type:Organization
Organization Name:DR. PADMAPRIYA BALAKRISHNA M. D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PADMAPRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAKRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:502-494-4718
Mailing Address - Street 1:10300 LINN STATION RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3840
Mailing Address - Country:US
Mailing Address - Phone:502-494-4718
Mailing Address - Fax:888-577-7895
Practice Address - Street 1:10300 LINN STATION RD
Practice Address - Street 2:SUITE 400
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3840
Practice Address - Country:US
Practice Address - Phone:502-494-4718
Practice Address - Fax:888-577-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37367261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service