Mark Alan Puckett in Louisville - Sports Medicine
Mark Alan Puckett - NPI 1649430794
Mark Alan Puckett is a Sports Medicine in Louisville, Kentucky. Mark Alan Puckett practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Mark Alan Puckett is 1649430794. The last update date is 2020-12-17.
Mark Alan Puckett's current location address is 2400 Eastpoint Pkwy, Louisville, Kentucky. You can contact this provider via phone number 5022536699 and fax number 5022536670. The mailing address for Mark Alan Puckett is 2400 Eastpoint Pkwy, Louisville, Kentucky. To know further, please read the information below!
Provider Profile Detail
Provider Name | Mark Alan Puckett |
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Address | 2400 Eastpoint Pkwy, Louisville, Kentucky |
Phone Number | 5022536699 |
Fax Number | 5022536670 |
Sole Proprietor | N |
Credentials | -- |
NPI Number Detail
NPI Number | 1649430794 |
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Provider Enumeration Date | 2008-06-12 |
Last Updated Date | 2020-12-17 |
Provider Mailing Address Detail
Address | 2400 Eastpoint Pkwy |
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City | Louisville |
State | Kentucky (KY) |
Post Code | 402234154 |
Phone Number | 5022536699 |
Fax Number | 5022536670 |
Provider's Primary Taxonomy Detail
Speciality | Sports Medicine |
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Taxonomy | 207Qs0010X |
Licence No | 45394 |
Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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7100209760 | KY | -- |
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What is the unique identification code assigned to Mark Alan Puckett by the Centers for Medicare & Medicaid Services?
The Mark Alan Puckett has been issued the NPI (National Provider Identifier) 1649430794. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Mark Alan Puckett?
The Mark Alan Puckett is physically situated at 2400 Eastpoint Pkwy, in the city of Louisville, state of KY, with the postal code 402234154.
What is the Mark Alan Puckett's area of specialization and corresponding taxonomy classification?
The Mark Alan Puckett's specialty field is Sports Medicine, and it falls under the taxonomy code 207Qs0010X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1649430794 to Mark Alan Puckett?
The Mark Alan Puckett received its 1649430794 assignment from the Centers for Medicare & Medicaid Services on 2008-06-12.
As of what date were the Mark Alan Puckett's details last updated?
The information pertaining to the Mark Alan Puckett, including its address, specialty, and other details, was most recently updated on 2020-12-17.