# CENTRAL KENTUCKY SURGERY, PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRAL KENTUCKY SURGERY, PSC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881778397
- **Legal business name:** CENTRAL KENTUCKY SURGERY, PSC
- **Authorized official:** CHRISTIAN KNECHT MD (SECRETARY)
- **Authorized official phone:** (800) 559-6614

## Contact information

- **Practice address:** 140 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
- **Practice address phone:** (800) 559-6614
- **Mailing address:** 1110 LANCASTER RD, SUITE 3, RICHMOND, KY 40475-8792
- **Mailing address phone:** (859) 623-3576

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 10/18/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 65921579 | — | KY |
| 01 | — | CM4690 | TRAVELERS MEDICARE | — |