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Organization

KELLY BURGESS M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY R BURGESS M.D. (DOCTOR)
(502) 863-5150
Entity
Organization

Contact information

Practice address
1140 LEXINGTON RD, SUITE 200, GEORGETOWN, KY 40324-9330
(502) 863-5150
(502) 863-4487
Mailing address
1140 LEXINGTON RD, SUITE 200, GEORGETOWN, KY 40324-9330
(502) 863-5150
(502) 863-4487

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000368877
BCBS
KY
05
64017783
KY
01
G63969
UPIN
KY
Enumeration date
05/19/2008
Last updated
06/18/2008
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