MEDICARE: KENTUCKY ORTHOPAEDICS & SPINE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	213ES0103X	Foot & Ankle Surgery Podiatrist
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	363A00000X	Physician Assistant
4	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083185938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKY ORTHOPAEDICS & SPINE PLLC

Provider Business Mailing Address
First Line	:	404 SHOPPERS DR
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1378
Country	:	US
Telephone Number	:	859-737-5333
Fax Number	:	859-737-0070

Provider Business Practice Location Address
First Line	:	404 SHOPPERS DR
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1378
Country	:	US
Telephone Number	:	859-737-5333
Fax Number	:	859-737-0070

Authorized Official
Title or Position	:	SR PARTNER
Name	:	GREGORY F GRAU
Credential	:	MD
Telephone Number	:	859-737-5333

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	05/02/2025

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Directions to “KENTUCKY ORTHOPAEDICS & SPINE PLLC ” Practice Location

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