=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851255921
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERIWOUND PHYSICIANS KY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6301 BASS RD
-----------------------------------------------------
City | PROSPECT
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40059-9384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-273-9800
-----------------------------------------------------
Fax | 216-273-9998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6150 PARKLAND BLVD STE 225
-----------------------------------------------------
City | MAYFIELD HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-6149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-273-9800
-----------------------------------------------------
Fax | 216-273-9998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | SAMSON FIXLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-273-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------