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General NPI Number Information
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NPI Number | 1194326033
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Entity Type | Organization
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Legal Business Name | KENTUCKY ORTHOPEDIC NETWORK
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 312 S 4TH ST STE 700
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City | LOUISVILLE
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State | KY
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Zip | 40202-3046
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Country | US
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Telephone | 918-528-3832
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Fax |
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Provider Business Mailing Address
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Address Line | 7521 S OLYMPIA AVE # 1041
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City | TULSA
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State | OK
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Zip | 74132-1855
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Country | US
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Telephone | 918-830-1090
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHRISTOPHER PARKS
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Credential | AUTH. OFFICIAL
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Telephone | 918-830-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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