Organization
BUC CRESCENT SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT R SO MD (MEDICAL DIRECTOR)
(859) 344-7900
Entity
Organization
Contact information
Practice address
2327 BUTTERMILK XING, CRESCENT SPRINGS, KY 41017-1622
(859) 344-7900
(859) 344-0099
Mailing address
2327 BUTTERMILK XING, CRESCENT SPRINGS, KY 41017-1622
(859) 344-7900
(859) 344-0099
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144556
—
OH
05
—
7100272280
—
KY
05
—
7100415420
—
KY
05
—
7100420760
—
KY
Enumeration date
11/09/2012
Last updated
12/15/2016
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