Organization
CENTRAL KENTUCKY ANESTHESIA P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS BROSTER M.D. (PRESIDENT)
(859) 268-1030
Entity
Organization
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6100
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1329545
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1329545
UMWA
KY
05
—
7100191870
—
KY
Enumeration date
10/23/2006
Last updated
05/21/2013
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