Organization
TWIN LAKES ANESTHESIOLOGY AND PAIN MANAGEMENT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET L. LANGDON (OFFICE MANAGER)
(270) 259-9470
Entity
Organization
Contact information
Practice address
904 WALLACE AVE, LEITCHFIELD, KY 42754-1418
(270) 259-9470
(270) 259-1662
Mailing address
904 WALLACE AVE, LEITCHFIELD, KY 42754-1418
(270) 259-9470
(270) 259-1662
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
TP490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000485100
BLUE PREFERRED
KY
01
—
274629400
PASSPORT ADVANTAGE
KY
01
—
50011448
PASSPORT
KY
Enumeration date
06/09/2006
Last updated
10/19/2007
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