Provider Demographics
NPI:1235169228
Name:ALLERGY & ASTHMA PHYSICIANS OF CENTRAL KENTUCKY, PSC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA PHYSICIANS OF CENTRAL KENTUCKY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-276-1452
Mailing Address - Street 1:166 PASADENA DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2973
Mailing Address - Country:US
Mailing Address - Phone:859-276-1452
Mailing Address - Fax:859-277-1237
Practice Address - Street 1:166 PASADENA DR
Practice Address - Street 2:SUITE 150
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2973
Practice Address - Country:US
Practice Address - Phone:859-276-1452
Practice Address - Fax:859-277-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65902272Medicaid
KY7100172090Medicaid
KY7100172090Medicaid