Organization
ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE OF KY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS D CERVONI MD (MANAGER)
(859) 624-4110
Entity
Organization
Contact information
Practice address
789 EASTERN BYP STE 5, RICHMOND, KY 40475-2407
(859) 624-4110
(859) 624-1968
Mailing address
789 EASTERN BYP STE 5, RICHMOND, KY 40475-2407
(859) 624-4110
(859) 624-1968
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000311396
BLUECROSS BLUESHIELD
KY
05
—
65940025
—
KY
01
—
DB5273
TRAVELERS MEDICARE
KY
Enumeration date
02/28/2007
Last updated
06/11/2010
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