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Organization
BIG SANDY UROLOGY PSC
Active
Organization
BIG SANDY UROLOGY PSC
Active
Other names
WILLIAM C. THORNDYKE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CHARLES THORNDYKE MDCM FRCS (OWNER)
(606) 638-1311
Entity
Organization
Contact information
Practice address
2489 HWY 644, SUITE 202, LOUISA, KY 41230
(606) 638-1311
(606) 638-3739
Mailing address
PO BOX 569, LOUISA, KY 41230-0569
(606) 638-1311
(606) 638-3739
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
29406
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051680
ANTHEM
KY
05
—
0010829000
—
WV
05
—
2764629
—
OH
01
—
5188137
AETNA
KY
05
—
65929366
—
KY
Enumeration date
06/27/2006
Last updated
09/02/2008
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