Organization
BLUEGRASS PATHOLOGY ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD J TANOUS JR. MD (PRESIDENT)
(859) 745-3500
Entity
Organization
Contact information
Practice address
175 HOSPITAL DRIVE, WINCHESTER, KY 40391-1169
(859) 745-3500
(859) 737-8350
Mailing address
3529 SOLUTIONS CENTER, CHICAGO, IL 60677-3005
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65916280
—
KY
Enumeration date
04/03/2007
Last updated
09/25/2012
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