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MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES NPI 1588797401


NPI Information

NPI: 1588797401
Provider Name: MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES

Doing Business As: LONDON CARDIO-VASCULAR SURGERY

Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
803 MEYERS BAKER RD
STE 150
LONDON, KY
ZIP 40741
Phone: (606) 862-9280
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MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES is a thoracic surgery cardiothoracic vascular surgery in London, KY. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES NPI is 1588797401. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As London Cardio-vascular Surgery.

The provider's business location address is:

803 MEYERS BAKER RD
STE 150
LONDON, KY
ZIP 40741-039
Phone: (606) 862-9280
Fax: (606) 877-3978

The provider's authorized official is Kandi Renee Rea .
The authorized official title is Physician Credentialing and has the following contact phone number (606) 877-3931.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 8/22/2020.


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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

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
1000000377922OTHERKENTUCKYANTHEM GROUP
265938177MEDICAIDKENTUCKY

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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