Elite Internal Medicine
Internal Medicine in Prospect, KY. Organization (NPI-2).
NPI number1033597828
StatusActive
Last updated in NPPESMay 6, 2022
Details
- NPI
- 1033597828
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Internal Medicine
- Organization subpart
- No
- Enumeration date
- May 12, 2015
- Certification date
- May 6, 2022
- Last updated
- May 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Other names
- Prospect Internal Medicine (Doing Business As)
Practice location
9537 Us Highway 42Prospect, KY 40059-9301
Phone 502-713-1332 · Fax 502-713-1218
Mailing address
Po Box 319Prospect, KY 40059-0319
Phone 502-713-1332 · Fax 502-713-1218
Other practice locations
10501 Fischer Park Dr
Louisville, KY 40241-4139
Louisville, KY 40241-4139
Phone 502-713-1218 · Fax 502-713-1218
Authorized official
Tina Yuan
Owner
5027131332
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