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General NPI Number Information
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NPI Number | 1063698991
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF KENTUCKY
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 100 AIRPORT GARDENS RD SUITE 7
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City | HAZARD
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State | KY
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Zip | 41701-9529
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Country | US
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Telephone | 859-257-7922
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 ALUMNI PARK PLZ SUITE 200
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City | LEXINGTON
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State | KY
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Zip | 40517-4012
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Country | US
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Telephone | 859-218-5678
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MIKE STANLEY
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Credential |
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Telephone | 606-439-3557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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