Provider Demographics
NPI:1548858301
Name:MARC J. SALZMAN, M.D. PSC
Entity type:Organization
Organization Name:MARC J. SALZMAN, M.D. PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:SALZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-299-9900
Mailing Address - Street 1:4702 CHAMBERLAIN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1106
Mailing Address - Country:US
Mailing Address - Phone:502-425-5200
Mailing Address - Fax:502-425-7900
Practice Address - Street 1:4702 CHAMBERLAIN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1106
Practice Address - Country:US
Practice Address - Phone:502-425-5200
Practice Address - Fax:502-425-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE