Provider Demographics
NPI:1306635297
Name:KENTUCKY CENTER FOR ADVANCED NEUROMODULATION
Entity type:Organization
Organization Name:KENTUCKY CENTER FOR ADVANCED NEUROMODULATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRODT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-327-7701
Mailing Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3604
Mailing Address - Country:US
Mailing Address - Phone:502-327-7701
Mailing Address - Fax:
Practice Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3604
Practice Address - Country:US
Practice Address - Phone:502-327-7701
Practice Address - Fax:502-327-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty