# KENTUCKY HEART INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENTUCKY HEART INSTITUTE
- **Other names:** Tri-State Vascular Specialists
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346539541
- **Legal business name:** KENTUCKY HEART INSTITUTE
- **Authorized official:** SARA MARKS (VICE-PRESIDENT)
- **Authorized official phone:** (606) 324-4745

## Contact information

- **Practice address:** 613 23RD ST, SUITE 140, ASHLAND, KY 41101-2878
- **Practice address phone:** (606) 326-1675
- **Practice address fax:** (606) 326-1436
- **Mailing address:** PO BOX 2380, ASHLAND, KY 41105-2380
- **Mailing address phone:** (606) 326-1675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | 3007367 | KY | — |

## Other

- **Enumeration date:** 03/29/2011
- **Last updated:** 06/18/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3135842 | — | OH |
| 05 | — | 3810020985 | — | WV |
| 05 | — | 7100162260 | — | KY |
| 05 | — | 7100164890 | — | KY |