Organization
SLEEP CENTER OF KENTUCKIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHEDER KUTMAH MD (MEDICAL DIRECTOR)
(502) 964-2440
Entity
Organization
Contact information
Practice address
7926 PRESTON HWY STE 200, LOUISVILLE, KY 40219-3848
(502) 964-2440
Mailing address
7926 PRESTON HWY STE 200, LOUISVILLE, KY 40219-3848
(502) 964-2440
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000509309
ANTHEM
KY
05
—
65946014
—
KY
Enumeration date
09/29/2006
Last updated
12/11/2007
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