Organization
CENTRAL KENTUCKY SURGEONS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H. LACY M.D. (PRESIDENT)
(859) 236-2222
Entity
Organization
Contact information
Practice address
130 DANIEL DR, DANVILLE, KY 40422-2527
(859) 236-2222
(859) 236-2227
Mailing address
130 DANIEL DR, DANVILLE, KY 40422-2527
(859) 236-2222
(859) 236-2227
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65903395
—
KY
Enumeration date
01/17/2007
Last updated
05/31/2017
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