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Organization

BLUEGRASS WOMENS CENTER PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM EARL TRENT MD (OWNER PHYSICIAN)
(502) 225-6800
Entity
Organization

Contact information

Practice address
120 E ADAMS ST, SUITE 6, LA GRANGE, KY 40031-1278
(502) 225-6800
(502) 225-6803
Mailing address
120 E ADAMS ST, SUITE 6, LA GRANGE, KY 40031-1278
(502) 225-6800
(502) 225-6803

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02725
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000202890
ANTHEM
KY
01
1153124
PASSPORT
KY
01
2438729000
PASSPORT ADVANTAGE
KY
01
4601014
AETNA
05
64040942
KY
Enumeration date
11/22/2006
Last updated
02/24/2009
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