Healthcare Provider Details

I. General information

NPI: 1144488743
Provider Name (Legal Business Name): GEORGETOWN OBSTETRICS AND GYNECOLOGY PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 LEXINGTON RD
GEORGETOWN KY
40324-9330
US

IV. Provider business mailing address

1158 LEXINGTON RD
GEORGETOWN KY
40324-9330
US

V. Phone/Fax

Practice location:
  • Phone: 502-868-0338
  • Fax: 502-868-0438
Mailing address:
  • Phone: 502-868-0338
  • Fax: 502-868-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number3331M
License Number StateKY

VIII. Authorized Official

Name: DR. CURTIS L. HIGH JR.
Title or Position: PRESIDENT/PHYSICIAN
Credential: MD
Phone: 502-868-0338