# BUFFALO TRACE EAR, NOSE & THROAT CENTER

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

## Provider details

- **NPI number:** 1871673046
- **Authorized official:** DR. ALFRED M SASSLER DO (PRESIDENT)
- **Authorized official phone:** (606) 759-5286

## Contact information

- **Practice address:** 1925 OLD MAIN ST, SUITE 1, MAYSVILLE, KY 41056-8984
- **Practice address phone:** (606) 759-5286
- **Practice address fax:** (606) 759-5773
- **Mailing address:** 4980 AA HWY N, FOSTER, KY 41043-9271
- **Mailing address phone:** (606) 747-5077
- **Mailing address fax:** (606) 759-5773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 34006187S | KY | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000050862 | ANTHEM ID NUMBER | KY |
| 05 | — | 0986107 | — | OH |
| 05 | — | 64024201 | — | KY |