Provider Demographics
NPI:1730950270
Name:BAPTIST HEALTH MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:BAPTIST HEALTH MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANYEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-253-4911
Mailing Address - Street 1:2400 EASTPOINT PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4154
Mailing Address - Country:US
Mailing Address - Phone:502-253-6689
Mailing Address - Fax:502-253-6680
Practice Address - Street 1:2400 EASTPOINT PKWY STE 120
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4154
Practice Address - Country:US
Practice Address - Phone:502-253-6689
Practice Address - Fax:502-253-6680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy