# BIG SANDY UROLOGY PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WILLIAM C. THORNDYKE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083641039
- **Authorized official:** DR. WILLIAM CHARLES THORNDYKE MDCM FRCS (OWNER)
- **Authorized official phone:** (606) 638-1311

## Contact information

- **Practice address:** 2489 HWY 644, SUITE 202, LOUISA, KY 41230
- **Practice address phone:** (606) 638-1311
- **Practice address fax:** (606) 638-3739
- **Mailing address:** PO BOX 569, LOUISA, KY 41230-0569
- **Mailing address phone:** (606) 638-1311
- **Mailing address fax:** (606) 638-3739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 29406 | KY | Yes |

## Other

- **Enumeration date:** 06/27/2006
- **Last updated:** 09/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000051680 | ANTHEM | KY |
| 05 | — | 0010829000 | — | WV |
| 05 | — | 2764629 | — | OH |
| 01 | — | 5188137 | AETNA | KY |
| 05 | — | 65929366 | — | KY |