# CENTRAL KENTUCKY ADULT & PEDIATRIC UROLOGY PSC

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

## Provider details

- **NPI number:** 1831226562
- **Authorized official:** MRS. MAE MARIE HILL (OFFICE MANAGER)
- **Authorized official phone:** (502) 868-7666

## Contact information

- **Practice address:** 1138 LEXINGTON RD, SUITE 110, GEORGETOWN, KY 40324-9672
- **Practice address phone:** (502) 868-7666
- **Practice address fax:** (502) 868-8060
- **Mailing address:** 1138 LEXINGTON RD, SUITE 110, GEORGETOWN, KY 40324-9672
- **Mailing address phone:** (502) 868-7666
- **Mailing address fax:** (502) 868-8060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 32238 | KY | Yes |

## Other

- **Enumeration date:** 02/28/2007
- **Last updated:** 06/25/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 65900581 | — | KY |