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Contact Information

MIDDLETOWN PEDIATRICS
301 C MIDDLETOWN PARK PLACE
LOUISVILLE, KY40243
 Phone: 502-244-9858
 Fax: 502-244-9575
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MIDDLETOWN PEDIATRICS

NPI # 1164645834
LBN Legal business name MIDDLETOWN PEDIATRICS
Authorized official DANA DISTLER - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2007
Last updated 03/12/2014 - About 12 years ago
Identifiers
KY License # 28883
KY License # 38964
KY License # 39163
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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