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NPI 1689865362

NPI 1689865362 : AMSOL ANESTHETISTS OF KENTUCKY PLLC : CORBIN, KY

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General NPI Number Information
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    NPI Number           |    1689865362
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMSOL ANESTHETISTS OF KENTUCKY PLLC 
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Dates
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    Enumeration Date     |    08/07/2007
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    Last Update Date     |    03/20/2009
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Provider Practice Location Address
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    Address Line         |    1 TRILLIUM WAY 
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    City                 |    CORBIN
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    State                |    KY
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    Zip                  |    40701-8426
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    Country              |    US
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    Telephone            |    910-892-7161
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 10824 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35202-0824
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    Country              |    US
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    Telephone            |    888-245-5525
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    Fax                  |    717-653-8197
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |     ALAN DALE HILLIARD 
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    Credential           |    
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    Telephone            |    910-892-7161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    
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    License Number State |    
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