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General NPI Number Information
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NPI Number | 1225452774
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Entity Type | Organization
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Legal Business Name | KENTUCKIANA ANESTHESIOLOGY, PLLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 5516 WEATHERBY LN
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City | PLANO
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State | TX
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Zip | 75093-3417
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Country | US
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Telephone | 214-577-7635
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Fax | 972-612-5811
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Provider Business Mailing Address
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Address Line | 5516 WEATHERBY LN
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City | PLANO
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State | TX
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Zip | 75093-3417
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Country | US
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Telephone | 214-577-7635
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Fax | 972-612-5811
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY W MCWHORTER
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Credential | M.D.
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Telephone | 214-577-7635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | J5406
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License Number State | TX
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