Organization
KENTUCKY MSO LLC
Active
Other names
Gastroenterology and Hepatology of the Bluegrass
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (CORPORATE SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1138 LEXINGTON RD, SUITE 140, GEORGETOWN, KY 40324-9672
(502) 570-3721
(502) 570-3722
Mailing address
1138 LEXINGTON RD, SUITE 140, GEORGETOWN, KY 40324-9672
(502) 570-3721
(502) 570-3722
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/08/2013
Last updated
04/21/2023
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