Organization
AMERICAN SURGICAL SPECIALISTS, PLLC
Active
Other names
Bluegrass Surgical Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP PARKER CRACE MD (OWNER)
(606) 886-1077
Entity
Organization
Contact information
Practice address
400 UNIVERSITY DR, SUITE 105, PRESTONSBURG, KY 41653-1080
(606) 886-1077
(606) 886-1170
Mailing address
400 UNIVERSITY DR, SUITE 105, PRESTONSBURG, KY 41653-1080
(606) 886-1077
(606) 886-1170
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
41691
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100011360
—
KY
05
—
7100152550
—
KY
Enumeration date
09/13/2010
Last updated
04/11/2011
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