MIDDLETOWN PEDIATRICS NPI 1164645834

NPI Information

MIDDLETOWN PEDIATRICS is an adolescent medicine pediatrics in Louisville, KY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MIDDLETOWN PEDIATRICS NPI is 1164645834. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

301 C MIDDLETOWN PARK PLACE
LOUISVILLE, KY
ZIP 40243
Phone: (502) 244-9858
Fax: (502) 244-9575

The provider's authorized official is Dana J. Distler .
The authorized official title is Physician/owner and has the following contact phone number (502) 244-9858.

The CLIA number assigned to this NPI record is 18D0907597 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 3/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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