Provider Demographics
NPI:1093895526
Name:KENTUCKY HAND CENTER PSC
Entity Type:Organization
Organization Name:KENTUCKY HAND CENTER PSC
Other - Org Name:ASSOCIATES FOR HAND AND ORTHOPEDIC SURGERY PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-9546
Mailing Address - Street 1:715 SHAKER DR
Mailing Address - Street 2:SUITE #104
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-278-9546
Mailing Address - Fax:859-277-8512
Practice Address - Street 1:715 SHAKER DR
Practice Address - Street 2:SUITE #104
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-278-9546
Practice Address - Fax:859-277-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15480207X00000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Not Answered2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00000045917OtherBLUE CROSS ANTHEM
KY64154800Medicaid
KY64154800Medicaid
KY64154800Medicaid
C69847Medicare UPIN