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Contact Information

UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC
9700 PARK PLAZA AVENUE
SUITE 110
LOUISVILLE, KY40241-2286
 Phone: 502-852-7670
 Fax: 502-852-7743
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for UNIVERSITY PEDIATRIC GASTROENTEROLOGY LLC · (Female)

NPI Number 1568790277
Status Active
Credentials
Entity Individual
Enumeration date 11/19/2009
Last updated 11/19/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 200945670
  • KY Medicaid 7100063520
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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