# KENTUCKY CARDIOTHORACIC SURGERY PLLC

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

## Provider details

- **NPI number:** 1063623619
- **Authorized official:** DR. SAMUEL B POLLOCK JR. MD (OWNER CARDIOTHORACIC SURGEON)
- **Authorized official phone:** (502) 899-3858

## Contact information

- **Practice address:** 3900 KRESGE WAY, LOUISVILLE, KY 40207-4660
- **Practice address phone:** (502) 810-8002
- **Mailing address:** PO BOX 7565, LOUISVILLE, KY 40257-0565
- **Mailing address phone:** (502) 810-8002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 05/25/2007
- **Last updated:** 10/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9590074200 | — | KY |