PEDIATRIC GASTROENTEROLOGY PSC NPI 1164455952

NPI Information

PEDIATRIC GASTROENTEROLOGY PSC is a clinic center in Louisville, KY. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PEDIATRIC GASTROENTEROLOGY PSC NPI is 1164455952. The provider is registered as an organization entity type.

The provider's business location address is:

233 E GRAY ST
SUITE 513
LOUISVILLE, KY
ZIP 40202-026
Phone: (502) 629-5796
Fax: (502) 629-5799

The provider's authorized official is Thgmas C Stephen .
The authorized official title is President and has the following contact phone number (502) 629-5796.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 5/19/2022.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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