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Organization
MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
Active
Organization
MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
Active
Other names
London Cardio-Vascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KANDI RENEE REA (PHYSICIAN CREDENTIALING)
(606) 877-3931
Entity
Organization
Contact information
Practice address
803 MEYERS BAKER RD, STE 150, LONDON, KY 40741-3039
(606) 862-9280
(606) 877-3978
Mailing address
740 E LAUREL RD, LONDON, KY 40741-8601
(606) 877-3931
(606) 877-3978
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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