Organization
THE LOUISVILLE BONE & JOINT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNA KHALILY MD (CEO/ PRESIDENT)
(502) 562-6021
Entity
Organization
Contact information
Practice address
210 E GRAY ST, STE 701, LOUISVILLE, KY 40202-3900
(502) 562-6021
(502) 562-6039
Mailing address
PO BOX 635191, CINCINNATI, OH 45263-0043
(513) 891-2813
(513) 793-1032
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200443290A
—
IN
01
—
2443212000
PASSPORT ADVANTAGE
KY
01
—
50001642
PASSPORT
KY
05
—
7100037410
—
KY
01
—
DE4059
RR MEDICARE
—
Enumeration date
08/23/2006
Last updated
06/12/2009
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