Healthcare Provider Details

I. General information

NPI: 1942251707
Provider Name (Legal Business Name): CENTRAL KENTUCKY PAIN MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N EAGLE CREEK DR SUITE 200
LEXINGTON KY
40509-1889
US

IV. Provider business mailing address

151 N EAGLE CREEK DR SUITE 200
LEXINGTON KY
40509-1889
US

V. Phone/Fax

Practice location:
  • Phone: 859-543-0561
  • Fax: 856-264-0183
Mailing address:
  • Phone: 859-543-0561
  • Fax: 856-264-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KARIM RASHEED
Title or Position: OWNER
Credential: M.D.
Phone: 859-543-0561