Organization
CENTRAL KENTUCKY SURGICAL INSTITUTE, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E BENTLEY M.D., FACS (PRESIDENT)
(270) 465-7505
Entity
Organization
Contact information
Practice address
1878 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9663
(270) 465-7505
(270) 789-3860
Mailing address
PO BOX 1114, CAMPBELLSVILLE, KY 42719-1114
(270) 465-7505
(270) 789-3860
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24667
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000062911
ANTHEM BCBS
KY
05
—
64246671
—
KY
Enumeration date
04/13/2007
Last updated
09/17/2014
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