Provider Demographics
NPI:1003040072
Name:KENTUCKY BARIATRIC, INC
Entity Type:Organization
Organization Name:KENTUCKY BARIATRIC, INC
Other - Org Name:NUYU HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-744-1061
Mailing Address - Street 1:4925 ROCKWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1928
Mailing Address - Country:US
Mailing Address - Phone:859-744-1061
Mailing Address - Fax:859-744-1062
Practice Address - Street 1:4925 ROCKWELL ROAD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1928
Practice Address - Country:US
Practice Address - Phone:859-744-1061
Practice Address - Fax:859-744-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty