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Organization

AMSOL ANESTHETISTS OF KENTUCKY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN DALE HILLIARD (CFO)
(910) 892-7161
Entity
Organization

Contact information

Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(910) 892-7161
Mailing address
PO BOX 10824, BIRMINGHAM, AL 35202-0824
(888) 245-5525
(717) 653-8197

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000555566
ANTHEM BLUE CROSS OF KENTUCKY
KY
05
7100027690
KY
01
C20398
CUMBERLAND HEALTHCARE
KY
Enumeration date
08/07/2007
Last updated
03/20/2009
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