# BLUEGRASS ORTHOPEDIC GROUP PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023217197
- **Authorized official:** DR. EUGNE JACOB MD (PRESIDENT)
- **Authorized official phone:** (502) 222-0598

## Contact information

- **Practice address:** 1023 NEW MOODY LN, STE 102, LA GRANGE, KY 40031-9177
- **Practice address phone:** (502) 222-0598
- **Practice address fax:** (502) 222-7446
- **Mailing address:** 1023 NEW MOODY LN, STE 102, LA GRANGE, KY 40031-9177
- **Mailing address phone:** (502) 222-0598
- **Mailing address fax:** (502) 222-7446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 23227 | KY | Yes |

## Other

- **Enumeration date:** 07/17/2007
- **Last updated:** 07/17/2007