Organization
CENTRAL KENTUCKY EAR, NOSE & THROAT, P.S.C.
Active
Other names
Kentucky Ear, Nose & Throat
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN RANDOLPH CPA (PRACTICE ADMINISTRATOR)
(859) 278-1114
Entity
Organization
Contact information
Practice address
1720 NICHOLASVILLE RD, SUITE 500, LEXINGTON, KY 40503-1404
(859) 278-1114
(859) 278-3774
Mailing address
1720 NICHOLASVILLE RD, SUITE 500, LEXINGTON, KY 40503-1404
(859) 278-1114
(859) 278-3774
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI8554
RAILROAD MEDICARE ID
—
Enumeration date
12/26/2006
Last updated
10/22/2012
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