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Organization

WESTERN BAPTIST MEDICAL VENTURES, INC

Active
Parent organization
WESTERN BAPTIST MEDICAL VENTURES, INC
Other names
W. KENTUCKY SURGICAL ASSOCIATES
Organization subpart
Yes

Provider details

NPI number
Legal business name
WESTERN BAPTIST MEDICAL VENTURES, INC
Authorized official
MR. LARRY O BARTON (VICE PRESIDENT)
(270) 575-2100
Entity
Organization

Contact information

Practice address
2603 KENTUCKY AVE, SUITE 103, PADUCAH, KY 42003-3814
(270) 415-7724
(270) 415-7727
Mailing address
PO BOX 7309, PADUCAH, KY 42002-7309
(270) 744-9600
(270) 744-0834

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other

Enumeration date
08/13/2007
Last updated
11/14/2011
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