Organization
KENTUCKY MEDICAL SERVICES FOUNDATION, INC
Active
Parent organization
KENTUCKY MEDICAL SERVICES FOUNDATION, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKY MEDICAL SERVICES FOUNDATION, INC
Authorized official
DR. MARCUS E RANDALL (AUTHROIZED OFFICIAL, CHAIR, DEPARTM)
(859) 257-7618
Entity
Organization
Contact information
Practice address
845 ANGLIANA AVE, LEXINGTON, KY 40508-3146
(859) 323-9321
(859) 257-5232
Mailing address
UK HEALTHCARE MEDICAL STAFF AFFAIRS, 740 S. LIMESTONE K005Q, LEXINGTON, KY 40536-0284
(859) 323-2374
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
175T00000X
Peer Specialist
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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