Provider Demographics
NPI:1164400701
Name:ANESTHESIOLOGY ASSOCIATES PSC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-458-7400
Mailing Address - Street 1:3101 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2742
Mailing Address - Country:US
Mailing Address - Phone:502-458-7400
Mailing Address - Fax:502-458-7449
Practice Address - Street 1:3101 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2742
Practice Address - Country:US
Practice Address - Phone:502-458-7400
Practice Address - Fax:502-458-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCH6488OtherRAILROAD MEDICARE GROUP NUMBER
KYCB0341OtherRAILROAD MEDICARE GROUP NUMBER
KYCD4773OtherRAILROAD MEDICARE GROUP NUMBER
KYCD4773OtherRAILROAD MEDICARE GROUP NUMBER