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Organization

HEAD AND NECK SURGERY ASSOCIATES, PSC

Active
Parent organization
HEAD AND NECK SURGERY ASSOCIATES
Other names
Center for Surgical Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
HEAD AND NECK SURGERY ASSOCIATES
Authorized official
JESSICA DETRICK (COO)
(859) 572-4104
Entity
Organization

Contact information

Practice address
7575 US 42, FLORENCE, KY 41042-1939
(859) 781-4900
(859) 572-3035
Mailing address
40 N GRAND AVE STE 103, FORT THOMAS, KY 41075-1771
(859) 781-4900
(859) 572-3039

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300097
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000198567
ANTHEM
01
300097
KY LICENSE
KY
05
36000735
KY
01
490002867
MEDICARE RR
01
6800084
UNITED HEALTHCARE
Enumeration date
11/01/2006
Last updated
04/27/2018
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