Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Mar 25, 2017
License(s)
R4330 (KY), 55520 (KY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 632572 | Cincinnati, OH 45263-2572 | 859-341-2666 |
| LOCATION | 1 MEDICAL VILLAGE DR | Edgewood, KY 41017-3403 | 859-301-2000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.