Provider Demographics
NPI:1033545249
Name:INTEGRITY ORTHOPAEDICS SPORTS MEDICINE AND REHABILITATION PLLC
Entity Type:Organization
Organization Name:INTEGRITY ORTHOPAEDICS SPORTS MEDICINE AND REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-497-4144
Mailing Address - Street 1:101 JB SHANNON DR
Mailing Address - Street 2:SUITES A & B
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-9812
Mailing Address - Country:US
Mailing Address - Phone:859-497-4144
Mailing Address - Fax:859-497-4137
Practice Address - Street 1:101 JB SHANNON DR
Practice Address - Street 2:SUITES A & B
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-9812
Practice Address - Country:US
Practice Address - Phone:606-209-0010
Practice Address - Fax:606-209-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100377680Medicaid
KY7100377680Medicaid