Healthcare Provider Details

I. General information

NPI: 1598878035
Provider Name (Legal Business Name): NORTHERN KENTUCKY GENERAL & VASCULAR SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 ALEXANDRIA PIKE
COLD SPRING KY
41076-1792
US

IV. Provider business mailing address

3700 ALEXANDRIA PIKE
COLD SPRING KY
41076-1792
US

V. Phone/Fax

Practice location:
  • Phone: 859-441-3818
  • Fax: 859-441-1758
Mailing address:
  • Phone: 859-441-3818
  • Fax: 859-441-1758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: DR. LANA G SCHAAF
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-441-3818