Unknown Individual – Family Medicine Physician, NPI 1629007620
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Box Car Way, Louisville, Jefferson County, Kentucky, 40272, United States
LOUISVILLE, KY 402950202
Phone: (502) 588-9490
Fax: (502) 272-5116
Type: Mailing
3118, East 10th Street, Jeffersonville, Clark County, Indiana, 47130, United States
JEFFERSONVILLE, IN 471305904
Phone: (812) 282-6979
Fax: (812) 282-6998
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40295)
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