Organization
KENTUCKY ANESTHESIA GROUP, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SKINNER D.O. (PRESIDENT)
(859) 268-1030
Entity
Organization
Contact information
Practice address
1140 LEXINGTON ROAD, GEORGETOWN, KY 40324
(502) 868-1100
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100194910
—
KY
05
—
7100194990
—
KY
Enumeration date
10/03/2006
Last updated
05/21/2013
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