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Organization
PEDIATRIX MEDICAL GROUP OF KENTUCKY PSC
Active
Organization
PEDIATRIX MEDICAL GROUP OF KENTUCKY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ASHFORD (ASSISTANT SECRETARY)
(800) 243-3839
Entity
Organization
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6580
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
(804) 253-0408
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65937344
—
KY
Enumeration date
09/17/2006
Last updated
11/05/2024
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