Healthcare Provider Details

I. General information

NPI: 1073589370
Provider Name (Legal Business Name): THE CRANLEY SURGICAL ASSOC,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL VILLAGE DR SUITE 394
EDGEWOOD KY
41017-5401
US

IV. Provider business mailing address

20 MEDICAL VILLAGE DR SUITE 394
EDGEWOOD KY
41017-5401
US

V. Phone/Fax

Practice location:
  • Phone: 859-578-0442
  • Fax: 859-578-9113
Mailing address:
  • Phone: 859-578-0442
  • Fax: 859-578-9113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. KAREN E PALATCHI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 513-961-4335