Healthcare Provider Details

I. General information

NPI: 1457406019
Provider Name (Legal Business Name): ANTHONY R UY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 11/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 LANGDON ST
SOMERSET KY
42503-2792
US

IV. Provider business mailing address

355 LANGDON ST
SOMERSET KY
42503-2792
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-8391
  • Fax: 606-678-4033
Mailing address:
  • Phone: 606-679-8391
  • Fax: 606-678-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY R UY
Title or Position: CHIEF FINANCIAL OFFICER
Credential: M.D.
Phone: 606-679-8391