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General NPI Number Information
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NPI Number | 1598816209
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Entity Type | Organization
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Legal Business Name | KENTUCKY ORTHOPEDIC SPECIALISTS PLLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 4402 CHURCHMAN AVENUE SUITE 406
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City | LOUISVILLE
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State | KY
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Zip | 40215
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Country | US
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Telephone | 502-367-1744
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Fax | 502-367-7993
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Provider Business Mailing Address
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Address Line | 4402 CHURCHMAN AVE STE 406
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City | LOUISVILLE
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State | KY
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Zip | 40215-1190
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Country | US
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Telephone | 502-367-1744
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PHILIP O DRIPCHAK
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Credential | M.D.
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Telephone | 502-367-1744
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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 | 32284
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License Number State | KY
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