Organization
KENTUCKY HEART INSTITUTE
Active
Parent organization
KENTUCKY HEART INSTITUTE
Other names
Tri-State Vascular Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKY HEART INSTITUTE
Authorized official
SARA MARKS (VICE-PRESIDENT)
(606) 324-4745
Entity
Organization
Contact information
Practice address
613 23RD ST, SUITE 140, ASHLAND, KY 41101-2878
(606) 326-1675
(606) 326-1436
Mailing address
PO BOX 2380, ASHLAND, KY 41105-2380
(606) 326-1675
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
3007367
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3135842
—
OH
05
—
3810020985
—
WV
05
—
7100162260
—
KY
05
—
7100164890
—
KY
Enumeration date
03/29/2011
Last updated
06/18/2012
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