Organization
UNIVERSITY SURGICAL ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY D. CROCKETT (CEO)
(502) 583-8303
Entity
Organization
Contact information
Practice address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Mailing address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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