Puerto, Alfonso

Puerto, Alfonso is an sole proprietor health care provider with primary practice located at 10806 Ward Ave , Louisville KY 40223-2659. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Puerto, Alfonso can be contacted via phone (502) 899-1246.

Contact Information

Primary practice address
10806 Ward Ave Louisville KY 40223-2659
Phone: (502) 899-1246
Fax: (502) 899-1292
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X LL339 Kentucky

Profile Details

NPI number 1669415808
LBN Legal business name Puerto, Alfonso
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Dec 7th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669415808 NPPES
Kentucky Other P100031756 MEDICARE PAY TO PROVIDER NUMBER
Kentucky Other 012087671 MEDICARE PAY TO PROVIDER NUMBER
Kentucky Other 1059063 MEDICARE PAY TO PROVIDER NUMBER
Kentucky MEDICAID 64993397 MEDICARE PAY TO PROVIDER NUMBER
Kentucky Other P400031727 MEDICARE PAY TO PROVIDER NUMBER

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