Organization
KENTUCKY MSO LLC
Active
Other names
Bluegrass Pediatrics and Internal Medicine-Georgetown
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
196 BEVINS LN, SUITE F, GEORGETOWN, KY 40324-8534
(502) 863-2818
(502) 863-2764
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/26/2016
Last updated
12/26/2016
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