Provider Demographics
NPI:1265695225
Name:BREES, CAROL K
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:K
Last Name:BREES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S JACKSON ST FL ST2
Mailing Address - Street 2:DEPT OB/GYN
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 S JACKSON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1622
Practice Address - Country:US
Practice Address - Phone:502-561-8850
Practice Address - Fax:502-561-8851
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27658207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000572381OtherANTHEM
KY50020465OtherPASSPORT FOUNDATION SPECIALITY
KY50020468OtherPASSPORT SPECIALITY PSC
KY000000571551OtherANTHEM
KY50020467OtherPASSPORT FOUNDATION PCP
KY7100054020Medicaid
KY50020468OtherPASSPORT SPECIALITY PSC
KY000000571551OtherANTHEM