Organization
BLUEGRASS GENERAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DAVID M FABER M.D. (OFFICE MANAGER)
(502) 348-5885
Entity
Organization
Contact information
Practice address
919 CHAMBERS BLVD STE D, BARDSTOWN, KY 40004-2574
(502) 348-5885
(502) 348-5898
Mailing address
919 CHAMBERS BLVD STE D, BARDSTOWN, KY 40004-2574
(502) 348-5885
(502) 348-5898
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32091
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64101538
—
KY
Enumeration date
01/18/2007
Last updated
05/12/2011
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