Organization
AUDUBON GI PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN R. CANLAS MD (PRESIDENT)
(270) 826-0002
Entity
Organization
Contact information
Practice address
1413 NORTH ELM ST, SUITE 105, HENDERSON, KY 42420-4266
(270) 826-0002
(270) 826-0003
Mailing address
PO BOX 1098, HENDERSON, KY 42419-1098
(270) 826-0002
(270) 826-0003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18731
KY
207RG0100X
Gastroenterology Physician
38601
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047502
BLUE CROSS BLUE SHIELD
KY
05
—
64187313
—
KY
Enumeration date
11/16/2006
Last updated
01/07/2010
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