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General NPI Number Information
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NPI Number | 1962790915
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Entity Type | Organization
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Legal Business Name | NES KENTUCKY, INC.
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 901 WESTLAKE DR
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City | COLUMBIA
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State | KY
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Zip | 42728-1123
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Country | US
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Telephone | 270-384-4753
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 503753
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City | SAINT LOUIS
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State | MO
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Zip | 63150-3753
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Country | US
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Telephone | 800-377-8721
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Fax | 304-697-1155
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Authorized Official
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Title or Position | DIRECTOR
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Name | SERGE MARTIAL
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Credential |
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Telephone | 800-242-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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