Broaddus, Emmett J.
Broaddus, Emmett J. is an individual health care provider with primary practice located at 3900 Kresge Way Suite 45, Louisville KY 40207-4660. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Broaddus, Emmett J. can be contacted via phone (502) 894-4418.Contact Information
Primary practice address
3900 Kresge Way Suite 45
Louisville KY 40207-4660
Phone: (502) 894-4418
Fax: (502) 894-8966
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 26593 | Kentucky |
Profile Details
| NPI number | 1760451314 |
|---|---|
| LBN Legal business name | Broaddus, Emmett J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 16th, 2006 |
| Last updated | Jun 17th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760451314 | NPPES |
| Kentucky | Other | 1167181 | PASSPORT |
| Kentucky | MEDICAID | 64265937 | PASSPORT |
| Kentucky | Other | 000000227076 | PASSPORT |
| Kentucky | Other | 110239071 | PASSPORT |
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