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Organization
HEAD AND NECK SURGERY ASSOCIATES, PSC
Active
Organization
HEAD AND NECK SURGERY ASSOCIATES, PSC
Active
Parent organization
HEAD AND NECK SURGERY ASSOCIATES
Other names
Center for Surgical Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEAD AND NECK SURGERY ASSOCIATES
Authorized official
JESSICA DETRICK (COO)
(859) 572-4104
Entity
Organization
Contact information
Practice address
7575 US 42, FLORENCE, KY 41042-1939
(859) 781-4900
(859) 572-3035
Mailing address
40 N GRAND AVE STE 103, FORT THOMAS, KY 41075-1771
(859) 781-4900
(859) 572-3039
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300097
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198567
ANTHEM
—
01
—
300097
KY LICENSE
KY
05
—
36000735
—
KY
01
—
490002867
MEDICARE RR
—
01
—
6800084
UNITED HEALTHCARE
—
Enumeration date
11/01/2006
Last updated
04/27/2018
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