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KENTUCKIANA EAR, NOSE & THROAT PSC

Physicians - Otolaryngology Facial Plastic Surgery

Louisville, Kentucky

Provider NPI: 1194771592

Organization Information:
Organization Name:  KENTUCKIANA EAR, NOSE & THROAT PSC


Practice Location:
6420 DUTCHMANS PKWY STE 380  LOUISVILLE, KY 40205 US
Tel: 502-894-8441  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207YX0602XPhysicians
Otolaryngology
Otolaryngic Allergy
N207YX0905XPhysicians
Otolaryngology
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Y207Y00000XPhysicians
Otolaryngology

Other Provider Identifiers:

IssuerNumberStateType
100001400IN05
65902710KY05
ANTHEM KY GP NUMBER000000057516KY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



PLASTIC SURGERY JOBS KY - Page 1



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