Provider Demographics
NPI:1174651491
Name:KENTUCKY ORTHOPEDIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:KENTUCKY ORTHOPEDIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:HINKEBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, ATC
Authorized Official - Phone:502-350-1079
Mailing Address - Street 1:104 FROMAN CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9430
Mailing Address - Country:US
Mailing Address - Phone:502-350-1079
Mailing Address - Fax:502-350-1079
Practice Address - Street 1:104 FROMAN CREEK CT
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9430
Practice Address - Country:US
Practice Address - Phone:502-350-1079
Practice Address - Fax:502-350-1079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90008145Medicaid
KY90008145Medicaid