Organization
BLUEGRASS ORTHOPEDIC GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGNE JACOB MD (PRESIDENT)
(502) 222-0598
Entity
Organization
Contact information
Practice address
1023 NEW MOODY LN, STE 102, LA GRANGE, KY 40031-9177
(502) 222-0598
(502) 222-7446
Mailing address
1023 NEW MOODY LN, STE 102, LA GRANGE, KY 40031-9177
(502) 222-0598
(502) 222-7446
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23227
KY
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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