Organization
KENTUCKIANA SURGICAL SPECIALISTS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN A O'KOON MD (OWNER)
(502) 897-6700
Entity
Organization
Contact information
Practice address
3900 KRESGE WAY STE 44, LOUISVILLE, KY 40207-4681
(502) 897-6700
(502) 897-6704
Mailing address
3900 KRESGE WAY, SUITE 44, LOUISVILLE, KY 40207-4660
(502) 897-6700
(502) 897-6704
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1172499
—
KY
05
—
65933244
—
KY
Enumeration date
07/05/2006
Last updated
12/13/2023
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