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Rex P Lagerstrom, MD

Internal Medicine in Louisville, KY. Individual provider (NPI-1).

NPI number1083679880
StatusActive
Last updated in NPPESDec 7, 2020

Details

NPI
1083679880
Entity type
Individual (NPI-1)
Name
Rex P Lagerstrom
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2006
Certification date
Dec 7, 2020
Last updated
Dec 7, 2020

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - INTERNAL MEDICINE
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine24848KYYes

Practice location

4003 Kresge Way Ste 410
Louisville, KY 40207-4652

Phone 502-893-7462 · Fax 502-212-7550

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176

Phone 502-253-4900 · Fax 502-489-5750

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine Physician providers in Louisville, KY

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