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General NPI Number Information
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NPI Number | 1073256665
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PHYSICIANS & SURGEONS, INC.
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1080 MEADOWBROOK LN
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City | LOUISA
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State | KY
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Zip | 41230-9657
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Country | US
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Telephone | 606-638-4389
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 10TH AVE STE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-691-8714
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JOHN MATTHEW STRAUB
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Credential |
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Telephone | 304-691-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 174H00000X
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Taxonomy Name | Health Educator
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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