# BLUEGRASS VEIN CLINIC

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

## Provider details

- **NPI number:** 1508483512
- **Authorized official:** JULIE SCHOENBAECHLER (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (502) 220-8437

## Contact information

- **Practice address:** 201 PROFESSIONAL PARK DR, GLASGOW, KY 42141-3486
- **Practice address phone:** (270) 392-3661
- **Practice address fax:** (580) 297-9310
- **Mailing address:** 106 TRIGG CT, GLASGOW, KY 42141-2252
- **Mailing address phone:** (270) 392-3661
- **Mailing address fax:** (580) 297-9310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/25/2020
- **Last updated:** 11/18/2021