Organization
SOUTHERN KENTUCKY ANESTHESIA SERVICES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON J PORTER MD (CEO)
(567) 201-6382
Entity
Organization
Contact information
Practice address
108 BRAVO BLVD, GLASGOW, KY 42141-3412
(270) 651-2181
Mailing address
108 BRAVO BLVD, GLASGOW, KY 42141-3412
(270) 651-2181
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/11/2011
Last updated
08/24/2011
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