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General NPI Number Information
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NPI Number | 1467568162
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Entity Type | Organization
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Legal Business Name | THE LOUISVILLE BONE & JOINT CENTER
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 210 E GRAY ST STE 701
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City | LOUISVILLE
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State | KY
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Zip | 40202-3900
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Country | US
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Telephone | 502-562-6021
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Fax | 502-562-6039
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Provider Business Mailing Address
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Address Line | PO BOX 635191
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City | CINCINNATI
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State | OH
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Zip | 45263-0043
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Country | US
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Telephone | 513-891-2813
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Fax | 513-793-1032
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | DR. CYNA KHALILY
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Credential | MD
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Telephone | 502-562-6021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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