Organization
GREATER LOUISVILLE ANESTHESIA SERVICES--DOWNTOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHON D LAVERTY CRNA (MGR/OWNER)
(502) 568-4800
Entity
Organization
Contact information
Practice address
444 S 1ST ST, C/O AESTHETIC PLASTIC SURGERY INSTITUTE, LOUISVILLE, KY 40202-1416
(502) 568-4800
(502) 222-8647
Mailing address
3401 BROECK POINTE CIR, LOUISVILLE, KY 40241-2531
(502) 568-4800
(502) 222-8647
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1089893/2802A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74900150
—
KY
Enumeration date
11/02/2006
Last updated
11/01/2007
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