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Organization
BLUEGRASS ORTHOPAEDIC GROUP PSC
Active
Organization
BLUEGRASS ORTHOPAEDIC GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE E JACOB MD (PRESIDENT)
(502) 895-1489
Entity
Organization
Contact information
Practice address
3920 DUTCHMANS LN, SUITE 314, LOUISVILLE, KY 40207-4702
(502) 895-1489
(502) 895-1261
Mailing address
3920 DUTCHMANS LN, SUITE 314, LOUISVILLE, KY 40207-4702
(502) 895-1489
(502) 895-1261
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
NULL
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
08/22/2020
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