Organization Name:  AMSURG NORTHERN KENTUCKY GI LLC


Practice Location:
340 THOMAS MORE PKWY SUITE 160B CRESTVIEW HILLS, KY 41017 US
Tel: 859-331-6466  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	KY	300131

Other Provider Identifiers:

Issuer	Number	State	Type
RAILROAD MEDICARE	P00883600	KY	01
	2278324	OH	05
	7100153030	KY	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin