COMMONWEALTH OF KENTUCKY NPI 1114346467

NPI Information

NPI: 1114346467
Provider Name: COMMONWEALTH OF KENTUCKY

Other Name: HAZELWOOD SPECIALTY CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1800 BLUEGRASS AVE
LOUISVILLE, KY
ZIP 40215
Phone: (502) 361-2301
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COMMONWEALTH OF KENTUCKY is a multi-specialty clinic center in Louisville, KY. COMMONWEALTH OF KENTUCKY NPI is 1114346467. The provider is registered as an organization entity type.
The provider Other Name Is Hazelwood Specialty Clinic.

The provider's business location address is:

1800 BLUEGRASS AVE
LOUISVILLE, KY
ZIP 40215-130
Phone: (502) 361-2301
Fax: (502) 366-0367

The provider's authorized official is Stephanie Craycraft .
The authorized official title is Acting Commissioner and has the following contact phone number (502) 782-6243.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/26/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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

NPI Synchronization or Removal

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