Provider Demographics
NPI:1154756500
Name:INTEGRITY ORTHOPAEDICS SPORTS MEDICINE AND REHABILITATION PLLC
Entity type:Organization
Organization Name:INTEGRITY ORTHOPAEDICS SPORTS MEDICINE AND REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHATTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-497-4144
Mailing Address - Street 1:624 MAYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9767
Mailing Address - Country:US
Mailing Address - Phone:859-497-4144
Mailing Address - Fax:859-498-4137
Practice Address - Street 1:160 PEDRO WAY
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-8354
Practice Address - Country:US
Practice Address - Phone:859-737-5188
Practice Address - Fax:859-737-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100330520OtherMEDICAID DME
KY6916150001Medicare NSC