| NPI | 1609847367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D. CROCKETT CEO 502-583-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| 2086X0206X Surgery, Surgical Oncology | |
| 208C00000X Colon & Rectal Surgery | |
| 231H00000X Audiologist | |
| 235Z00000X Speech-Language Pathologist, | |
| 363L00000X Nurse Practitioner | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2011-12-21 |