| NPI | 1083256242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY GAST Syst VP Mngd Care & Payor Strat 502-272-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2021-09-22 |