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General NPI Number Information
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NPI Number | 1528260734
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Entity Type | Organization
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Legal Business Name | KENTUCKY SURGICAL ARTS PSC
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 5251 KY ROUTE 321 KENTUCKY SURGICAL ARTS PSC
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9114
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Country | US
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Telephone | 606-886-0682
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Fax | 606-886-0682
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Provider Business Mailing Address
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Address Line | 5251 KY ROUTE 321 KENTUCKY SURGICAL ARTS PSC
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9114
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Country | US
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Telephone | 606-886-0682
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Fax | 606-886-0682
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Authorized Official
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Title or Position | M.D
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Name | MRS. KAMAR J IKRAMUDDIN
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Credential | MD
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Telephone | 606-886-0682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 19259
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 19463
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License Number State | KY
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