# KENTUCKIANA SURGICAL SPECIALISTS PSC

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

## Provider details

- **NPI number:** 1033140579
- **Authorized official:** KEVIN A O'KOON MD (OWNER)
- **Authorized official phone:** (502) 897-6700

## Contact information

- **Practice address:** 3900 KRESGE WAY STE 44, LOUISVILLE, KY 40207-4681
- **Practice address phone:** (502) 897-6700
- **Practice address fax:** (502) 897-6704
- **Mailing address:** 3900 KRESGE WAY, SUITE 44, LOUISVILLE, KY 40207-4660
- **Mailing address phone:** (502) 897-6700
- **Mailing address fax:** (502) 897-6704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 12/13/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1172499 | — | KY |
| 05 | — | 65933244 | — | KY |