Provider Demographics
NPI:1962735621
Name:ORTHO KENTUCKY DBA KENTUCKY BONE & JOINT SURGEONS
Entity type:Organization
Organization Name:ORTHO KENTUCKY DBA KENTUCKY BONE & JOINT SURGEONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAJADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-276-5008
Mailing Address - Street 1:216 FOUNTAIN CT STE 250
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2510
Mailing Address - Country:US
Mailing Address - Phone:859-276-5008
Mailing Address - Fax:859-278-6401
Practice Address - Street 1:216 FOUNTAIN CT STE 250
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2510
Practice Address - Country:US
Practice Address - Phone:859-276-5008
Practice Address - Fax:859-278-6401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHO KENTUCKY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-14
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207XX0005X, 207X00000X
KYPA1125363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100232300Medicaid
KY7100104260Medicaid