Provider Demographics
NPI:1992700025
Name:WOMEN'S CARE PHYSICIANS OF LOUISVILLE
Entity type:Organization
Organization Name:WOMEN'S CARE PHYSICIANS OF LOUISVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:KIRTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-897-0697
Mailing Address - Street 1:4130 DUTCHMANS LN
Mailing Address - Street 2:STE 400
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4711
Mailing Address - Country:US
Mailing Address - Phone:502-897-0697
Mailing Address - Fax:502-897-0658
Practice Address - Street 1:4130 DUTCHMANS LN
Practice Address - Street 2:STE 400
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4711
Practice Address - Country:US
Practice Address - Phone:502-897-0697
Practice Address - Fax:502-897-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1048735OtherPASSPORT
KY65924409Medicaid
KYCC6398OtherRAILROAD
KYCC6398OtherRAILROAD
KY=========OtherEMPLOYER ID