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KENTUCKIANA EAR NOSE & THROAT PSC NPI 1194771592


NPI Information

NPI: 1194771592
Provider Name: KENTUCKIANA EAR, NOSE & THROAT PSC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 18D2130686

Address:
6420 DUTCHMANS PKWY STE 380
LOUISVILLE, KY
ZIP 40205
Phone: (502) 894-8441
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KENTUCKIANA EAR, NOSE & THROAT PSC is an otolaryngology in Louisville, KY. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. KENTUCKIANA EAR, NOSE & THROAT PSC NPI is 1194771592. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6420 DUTCHMANS PKWY STE 380
LOUISVILLE, KY
ZIP 40205-355
Phone: (502) 894-8441
Fax: (502) 371-0929

The provider's authorized official is Bruce Scott .
The authorized official title is President and has the following contact phone number (812) 283-8770.

The CLIA number assigned to this NPI record is 18D2130686 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 2/16/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyYes
2207YX0602XOtolaryngologyOtolaryngic AllergyNo
3207YX0905XOtolaryngologyOtolaryngology/Facial Plastic SurgeryNo
4363L00000XNurse PractitionerNo
5363LF0000XNurse PractitionerFamilyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100001400MEDICAIDINDIANA
2000000057516OTHERKENTUCKYANTHEM KY GP NUMBER
365902710MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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