Organization
BLUEGRASS PEDIATRICS AND INTERNAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW P. BALBAUGH MD (PARTNER)
(502) 863-2818
Entity
Organization
Contact information
Practice address
196 BEVINS LN, SUITE F, GEORGETOWN, KY 40324-8534
(502) 863-2818
(502) 863-2764
Mailing address
196 BEVINS LN, SUITE F, GEORGETOWN, KY 40324-8534
(502) 863-2818
(502) 863-2764
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41057
KY
208000000X
Pediatrics Physician
Primary
41057
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100047760
—
KY
05
—
7100059860
—
KY
Enumeration date
03/14/2008
Last updated
12/22/2016
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