Healthcare Provider Details
I. General information
NPI: 1720587447
Provider Name (Legal Business Name): SOUND PHYSICIANS EMERGENCY MEDICINE OF KENTUCKY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2018
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 SAINT CHRISTOPHER DR
ASHLAND KY
41101-7034
US
IV. Provider business mailing address
3303 S MERIDIAN AVE
OKLAHOMA CITY OK
73119-1026
US
V. Phone/Fax
- Phone: 606-833-3333
- Fax:
- Phone: 800-962-3303
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
M
MCCARTY
Title or Position: GENERAL COUNSEL & SECRETARY
Credential:
Phone: 855-768-6363