# CENTRAL KENTUCKY SURGICAL SERVICES LLC

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

## Provider details

- **NPI number:** 1689701997
- **Authorized official:** SUSAN A. SHIVELY (OWNER)
- **Authorized official phone:** 27014652521

## Contact information

- **Practice address:** 1700 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9615
- **Practice address phone:** (270) 465-2521
- **Mailing address:** 803 LEBANON AVE, CAMPBELLSVILLE, KY 42718-1809
- **Mailing address phone:** (270) 465-2521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 08/17/2007