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General NPI Number Information
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NPI Number | 1972554855
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Entity Type | Organization
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Legal Business Name | BARIATRIC SURGICAL ASSOCIATES,PLLC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 1401 HARRODSBURG RD SUITE C100
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City | LEXINGTON
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State | KY
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Zip | 40504-3751
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Country | US
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Telephone | 859-278-4960
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Fax | 859-278-0033
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Provider Business Mailing Address
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Address Line | 160 N EAGLE CREEK DR SUITE 201
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City | LEXINGTON
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State | KY
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Zip | 40509-2121
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Country | US
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Telephone | 859-967-5520
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Fax | 859-967-5444
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWIN J. NIGHBERT
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Credential | M.D.
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Telephone | 859-967-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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