Healthcare Provider Details

I. General information

NPI: 1003866146
Provider Name (Legal Business Name): ANESTHESIA SERVICES OF KENTUCKY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 DUTCHMANS LN
LOUISVILLE KY
40207-4714
US

IV. Provider business mailing address

601 S FLOYD ST SUITE 407
LOUISVILLE KY
40202-1835
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-2880
  • Fax: 502-629-2879
Mailing address:
  • Phone: 502-629-2880
  • Fax: 502-629-2879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MUSHTAQUE M. JUNEJA
Title or Position: OWNER
Credential: MD
Phone: 502-629-2880