MEDICARE: PHYSICIAN SERVICES PSC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207T00000X	Neurological Surgery Physician
2	2084N0400X	Neurology Physician
3	2084P0800X	Psychiatry Physician
4	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician
5	2085N0700X	Neuroradiology Physician
6	332B00000X	Durable Medical Equipment & Medical Supplies

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	1026130003	OTHER	KY	NSC - DME
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	CD2933	OTHER	KY	RRMCR

General Provider Information

NPI Number	:	1154393973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN SERVICES PSC

Provider Business Mailing Address
First Line	:	PO BOX 22430
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40522-2430
Country	:	US
Telephone Number	:	859-224-0090
Fax Number	:	859-224-0094

Provider Business Practice Location Address
First Line	:	5001 HOUSTON RD
Second Line	:
City	:	FLORENCE
State	:	KY
Zip	:	41042
Country	:	US
Telephone Number	:	859-282-8678
Fax Number	:	859-282-8679

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN W GILBERT
Credential	:	MD
Telephone Number	:	859-252-6500

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	08/19/2009

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Directions to “PHYSICIAN SERVICES PSC ” Practice Location

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