Organization
PURCHASE ANESTHESIA, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER SCOTT LYKINS M.D. (PRESIDENT)
(859) 268-1030
Entity
Organization
Contact information
Practice address
225 MEDICAL CENTER DR, SUITE 405, PADUCAH, KY 42003-7914
(270) 441-4750
(270) 441-4770
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943524
—
KY
05
—
7100204540
—
KY
05
—
7100204570
—
KY
05
—
74900945
—
KY
01
—
DD8802
RAILROAD MEDICARE
KY
Enumeration date
05/11/2006
Last updated
01/24/2019
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