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KENTUCKIANA COLON AND RECTAL SURGERY PLLC NPI 1619908613


NPI Information

NPI: 1619908613
Provider Name: KENTUCKIANA COLON AND RECTAL SURGERY, PLLC
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization
Address:
4121 DUTCHMANS LN
SUITE 515
LOUISVILLE, KY
ZIP 40207
Phone: (502) 583-8005
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KENTUCKIANA COLON AND RECTAL SURGERY, PLLC is a colon rectal surgery in Louisville, KY. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. KENTUCKIANA COLON AND RECTAL SURGERY, PLLC NPI is 1619908613. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4121 DUTCHMANS LN
SUITE 515
LOUISVILLE, KY
ZIP 40207-737
Phone: (502) 583-8005

The provider's authorized official is Wayne Tuckson .
The authorized official title is Owner/physician and has the following contact phone number (502) 583-8005.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 8/13/2008.


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
1363L00000XNurse PractitionerNo
2208C00000XColon & Rectal Surgery30849KENTUCKYYes

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
165934739MEDICAIDKENTUCKY
2CK6017OTHERKENTUCKYRAILROAD MEDICARE
37129MEDICARE ID-TYPE UNSPECIFIEDKENTUCKY
47100015770MEDICAIDKENTUCKY
5200323220AMEDICAIDINDIANA

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: 11/14/2023

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