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Contact Information

EAST TENNESSEE WOUND CARE PC
4950 NORTON HEALTHCARE BLVD
SUITE 101
LOUISVILLE, KY40241-2845
 Phone: 502-446-6160
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for EAST TENNESSEE WOUND CARE PC

NPI Number 1568503993
LBN Legal business name EAST TENNESSEE WOUND CARE PC
Authorized official CARY KIRK - (SOLE OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/09/2007
Last updated 06/20/2013 - About 13 years ago
Identifiers
KY License # 21368
IN Medicaid 200828020A
KY Other 000000487847 ANTHEM BLUE CROSS BLUE SHIELD
KY Other 2789407000 PASSPORT ADVANTAGE
KY Other 50012967 PASSPORT HEALTH PLANS
KY Other DF7517 RAILROAD MEDICARE
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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