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General NPI Number Information
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NPI Number | 1144395286
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Entity Type | Organization
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Legal Business Name | BLUEGRASS WOMENS CENTER PLLC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 120 E ADAMS ST SUITE 6
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City | LA GRANGE
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State | KY
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Zip | 40031-1278
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Country | US
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Telephone | 502-225-6800
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Fax | 502-225-6803
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Provider Business Mailing Address
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Address Line | 120 E ADAMS ST SUITE 6
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City | LA GRANGE
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State | KY
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Zip | 40031-1278
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Country | US
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Telephone | 502-225-6800
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Fax | 502-225-6803
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | WILLIAM EARL TRENT
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Credential | MD
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Telephone | 502-225-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 02725
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License Number State | KY
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