Provider Demographics
NPI:1386934354
Name:UNIVERSITY OF KENTUCKY HEALTHCARE
Entity type:Organization
Organization Name:UNIVERSITY OF KENTUCKY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACULTY RECRUITMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-323-5962
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:MN 150
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-257-5548
Mailing Address - Fax:859-257-5549
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:MN 150
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-257-5548
Practice Address - Fax:859-257-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006742261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01013978Medicaid