Organization
AMSURG KENTUCKY OPHTHALMOLOGY LLC
Active
Other names
Bluegrass Surgery & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER A HOLDEN (CHIEF MANAGER OF LLC)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1400 POPLAR LEVEL RD, SUITE 1, LOUISVILLE, KY 40217-1309
(502) 637-4800
(502) 637-1550
Mailing address
1400 POPLAR LEVEL RD, SUITE 1, LOUISVILLE, KY 40217-1309
(502) 637-4800
(502) 637-1550
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300133
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3600107100
—
KY
01
—
611212775-004
HUMANA MILITARY, INC.
KY
Enumeration date
02/07/2006
Last updated
06/17/2008
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