Bluegrass Allergy Asthma And Immunology Psc
Internal Medicine, Allergy & Immunology in Louisville, KY. Organization (NPI-2).
NPI number1669984209
StatusActive
Last updated in NPPESJul 10, 2018
Details
- NPI
- 1669984209
- Entity type
- Organization (NPI-2)
- Legal business name
- Bluegrass Allergy Asthma And Immunology Psc
- Organization subpart
- No
- Enumeration date
- Nov 3, 2017
- Last updated
- Jul 10, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RA0201X | Internal Medicine, Allergy & Immunology | 34409 | KY | Yes |
Practice location
11900 Plantside Dr Ste 9Louisville, KY 40299
Phone 502-267-0556 · Fax 502-267-1715
Mailing address
Po Box 206578Louisville, KY 40250-6578
Phone 812-218-8926 · Fax 812-218-8930
Authorized official
Frank Tolis Simon
MD/Owner
5023864710
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