Healthcare Provider Details

I. General information

NPI: 1962735621
Provider Name (Legal Business Name): ORTHO KENTUCKY DBA KENTUCKY BONE & JOINT SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 FOUNTAIN CT STE 250
LEXINGTON KY
40509-2510
US

IV. Provider business mailing address

216 FOUNTAIN CT STE 250
LEXINGTON KY
40509-2510
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5008
  • Fax: 859-278-6401
Mailing address:
  • Phone: 859-276-5008
  • Fax: 859-278-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1125
License Number StateKY

VIII. Authorized Official

Name: DR. KAVEH R SAJADI
Title or Position: OWNER/PARTNER
Credential: MD
Phone: 859-276-5008