Speevack, Bernard Louis

Speevack, Bernard Louis is an sole proprietor health care provider with primary practice located at 417 Benjamin Lane Suite 101, Louisville KY 40222-4845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Speevack, Bernard Louis can be contacted via phone (502) 412-0597.

Contact Information

Primary practice address
417 Benjamin Lane Suite 101 Louisville KY 40222-4845
Phone: (502) 412-0597
Fax: (502) 412-4637
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20887 Kentucky

Profile Details

NPI number 1730178963
LBN Legal business name Speevack, Bernard Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2005
Last updated Sep 8th, 2020 - about 5 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 1730178963 NPPES
Kentucky Other 50028108 PASSPORT
Kentucky MEDICAID 64208879 PASSPORT
Kentucky Other 000000652903 PASSPORT
Kentucky Other 135410 PASSPORT
Kentucky Other 000000768482 PASSPORT

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