Organization
KENTUCKY MSO LLC
Active
Organization
KENTUCKY MSO LLC
Active
Other names
Georgetown Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (VICE PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1154 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 863-3329
(502) 863-3303
Mailing address
1154 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 863-3329
(502) 863-3303
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/26/2012
Last updated
03/02/2023
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