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General NPI Number Information
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NPI Number | 1871675991
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Entity Type | Organization
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Legal Business Name | ORTHO KENTUCKY DBA KENTUCKY BONE & JOINT SURGEONS
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/24/2010
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Provider Practice Location Address
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Address Line | 230 FOUNTAIN CT SUITE 180
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City | LEXINGTON
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State | KY
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Zip | 40509-1895
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Country | US
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Telephone | 859-276-5008
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Fax | 859-278-6401
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Provider Business Mailing Address
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Address Line | 230 FOUNTAIN CT SUITE 180
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City | LEXINGTON
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State | KY
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Zip | 40509-1895
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Country | US
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Telephone | 859-276-5008
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Fax | 859-278-6401
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Authorized Official
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Title or Position | CHIEF OFFICER
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Name | DR. KOOROS SAJADI
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Credential | M.D.
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Telephone | 859-276-5008
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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 | 19960
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License Number State | KY
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