Provider Demographics
NPI:1063595452
Name:BADA, JOSE SALVILLA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:SALVILLA
Last Name:BADA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 ZARING MILL CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-3035
Mailing Address - Country:US
Mailing Address - Phone:502-426-8924
Mailing Address - Fax:812-282-4293
Practice Address - Street 1:443 SPRING ST STE 200
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-4494
Practice Address - Country:US
Practice Address - Phone:812-288-8360
Practice Address - Fax:812-288-8375
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2024-02-08
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Provider Licenses
StateLicense IDTaxonomies
IN1047589A207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200473520AMedicaid
INH02547Medicare UPIN