| NPI | 1083098651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY GAST VP Managed Care 502-272-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207Q00000X Family Medicine | |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 207RN0300X Internal Medicine Nephrology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 208600000X Surgery | |
| 207V00000X Obstetrics & Gynecology | |
| 207VG0400X Obstetrics & Gynecology Gynecology | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 207P00000X Emergency Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2023-11-07 |