Organization
HYDEN EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization
Contact information
Practice address
130 KATE IRELAND DR, HYDEN, KY 41749-9071
(877) 693-5700
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000734305
BCBS
KY
05
—
1497036776
—
VA
05
—
7100198680
—
KY
01
—
DS5509
RR MCR
KY
01
—
K016290
MEDICARE PIN
KY
Enumeration date
08/31/2011
Last updated
03/23/2022
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