Organization
SURGICAL SPECIALISTS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD Y CHADWELL M.D. (PHYSICIAN)
(270) 769-5551
Entity
Organization
Contact information
Practice address
1700 RING RD, ELIZABETHTOWN, KY 42701-9497
(270) 769-5551
(270) 765-3919
Mailing address
1700 RING RD, ELIZABETHTOWN, KY 42701-9497
(270) 769-5551
(270) 765-3919
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1048712
PASSPORT GROUP
KY
05
—
65902207
—
KY
01
—
CB0393
RAILROAD MEDICARE
KY
Enumeration date
05/09/2006
Last updated
02/25/2008
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