Organization
BLUEGRASS CARDIOLOGY CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KYESHA ALLEN (OFFICE MANAGER)
(502) 875-9885
Entity
Organization
Contact information
Practice address
107 DIAGNOSTIC DR, FRANKFORT, KY 40601-6524
(502) 875-9885
(502) 875-9882
Mailing address
107 DIAGNOSTIC DR, FRANKFORT, KY 40601-6524
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
27319
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522398578
ANDREW BUSTIN, MD TAX ID
KY
05
—
64057623
—
KY
05
—
64199441
—
KY
05
—
64922230
—
KY
Enumeration date
06/18/2006
Last updated
05/29/2008
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