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General NPI Number Information
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NPI Number | 1588546469
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Entity Type | Organization
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Legal Business Name | SOUTHERN TRAVEL SURGERY PLLC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 54 IMAGING DR
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City | SOMERSET
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State | KY
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Zip | 42503-2871
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Country | US
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Telephone | 859-583-2744
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E PIKE ST
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City | CYNTHIANA
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State | KY
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Zip | 41031-1554
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Country | US
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Telephone | 859-287-4745
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Fax |
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Authorized Official
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Title or Position | OPERATOR
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Name | FRIEND BECHTEL
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Credential |
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Telephone | 859-447-9011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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