Louisville Neurosurgical Specialist PSC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

24702 Issued in KY

Legal business name

LOUISVILLE NEUROSURGICAL SPECIALIST PSC

Practice address

4010 Dupont Cir
Suite L28
Louisville, KY 40207-4812

Phone

(502) 899-9099

Fax

(502) 899-9899

NPI assigned

Jan 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Petruska, MD

Title

Owner Physician

Phone

(502) 899-9099

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Louisville Neurosurgical Specialist PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Louisville Neurosurgical Specialists, P.S.C.

  • Specialist
  • Louisville, KY
  • NPI 1225181639
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1184760357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE L28",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-899-9099",
            "fax_number": "502-899-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE L28",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-899-9099",
            "fax_number": "502-899-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE NEUROSURGICAL SPECIALIST PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "PETRUSKA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "502-899-9099",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "KY",
            "license": "24702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ID",
            "identifier": "50001903",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Neurological Surgery
• Louisville Neurology Associates PSC
• Louisville Neuropsychology LLC
• Louisville Neuroscience Institute PLLC
• Louisville Neuroscience Institute PLLC
• Louisville Neurosurgical Specialists, P.S.C.
• Louisville OB GYN PSC
• Louisville Observational Medicine Associates PSC
• Louisville Occupational and General Health Services LLC (The Loghs Clinic)
• Louisville Occupational Therapy, LLC

• Neurological Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neurological Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.