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General NPI Number Information
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NPI Number | 1760583165
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Entity Type | Organization
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Legal Business Name | KENTUCKY CARDIOLOGY, PLLC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 161 N EAGLE CREEK DR STE 400
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City | LEXINGTON
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State | KY
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Zip | 40509-9038
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Country | US
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Telephone | 859-226-0031
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Fax | 859-226-0041
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Provider Business Mailing Address
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Address Line | 161 N EAGLE CREEK DR STE 400
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City | LEXINGTON
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State | KY
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Zip | 40509-9038
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Country | US
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Telephone | 859-226-0031
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Fax | 859-226-0041
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KIMBERLY NOVAK
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Credential |
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Telephone | 859-226-0031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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