Provider Demographics
NPI:1053382424
Name:KUROWSKI, RENE ELLEN (MD)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:ELLEN
Last Name:KUROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENE
Other - Middle Name:ELLEN
Other - Last Name:FITZPATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1169 EASTERN PKWY STE 2265
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1479
Mailing Address - Country:US
Mailing Address - Phone:502-635-7455
Mailing Address - Fax:502-634-9296
Practice Address - Street 1:1169 EASTERN PKWY STE 2265
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1479
Practice Address - Country:US
Practice Address - Phone:502-635-7455
Practice Address - Fax:502-634-9296
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200327200Medicaid
KY50028442OtherPASSPORT
KY000000660924OtherANTHEM
KY64032972Medicaid
KYP400018492Medicare PIN