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ALL-STAR PEDIATRICS PSC NPI 1689774994


NPI Information

NPI: 1689774994
Provider Name: ALL-STAR PEDIATRICS PSC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 18D0984842

Address:
6425 BARDSTOWN RD
LOUISVILLE, KY
ZIP 40291
Phone: (502) 762-0498
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ALL-STAR PEDIATRICS PSC 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. ALL-STAR PEDIATRICS PSC NPI is 1689774994. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6425 BARDSTOWN RD
LOUISVILLE, KY
ZIP 40291-040
Phone: (502) 762-0498
Fax: (502) 762-0469

The provider's authorized official is Jean L Gee .
The authorized official title is Office Manager and has the following contact phone number (502) 762-0498.

The CLIA number assigned to this NPI record is 18D0984842 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 6/30/2008.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080A0000XPediatricsAdolescent Medicine37862KENTUCKYNo
22080A0000XPediatricsAdolescent Medicine27333KENTUCKYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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