Organization
BIG SANDY UROLOGY PSC
Active
Other names
WILLIAM C. THORNDYKE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CHARLES THORNDYKE MDCM FRCS (OWNER)
(606) 638-1311
Entity
Organization
Contact information
Practice address
2489 HWY 644, SUITE 202, LOUISA, KY 41230
(606) 638-1311
(606) 638-3739
Mailing address
PO BOX 569, LOUISA, KY 41230-0569
(606) 638-1311
(606) 638-3739
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
29406
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051680
ANTHEM
KY
05
—
0010829000
—
WV
05
—
2764629
—
OH
01
—
5188137
AETNA
KY
05
—
65929366
—
KY
Enumeration date
06/27/2006
Last updated
09/02/2008
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