Provider Demographics
NPI:1558334466
Name:PHYSICIAN SERVICES PSC
Entity type:Organization
Organization Name:PHYSICIAN SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-252-6500
Mailing Address - Street 1:1713 NICHOLASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1403
Mailing Address - Country:US
Mailing Address - Phone:859-252-6500
Mailing Address - Fax:859-224-0094
Practice Address - Street 1:1721 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1428
Practice Address - Country:US
Practice Address - Phone:859-252-6500
Practice Address - Fax:859-252-3073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207T00000X, 2084P0800X, 2085N0700X, 208VP0000X, 332B00000X, 332BC3200X, 332BN1400X, 363A00000X, 363AM0700X, 363AS0400X, 363L00000X, 363LA2200X, 363LX0106X
KY2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility SuppliesGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100241280Medicaid
KY7100246380Medicaid
KYCD2933OtherRAILROAD MCARE
KY3810003494OtherWV MEDICAID
KY7100241170Medicaid
KY7100244620Medicaid
KY65926552Medicaid
KY7100243230Medicaid
KY2472800OtherOHIO MEDICAID
KY7100241790Medicaid
KY90102344Medicaid
KY7100243230Medicaid
KY7100244620Medicaid