Provider Demographics
NPI:1235365537
Name:KENTUCKY HEART INSTITUTE INC
Entity Type:Organization
Organization Name:KENTUCKY HEART INSTITUTE INC
Other - Org Name:CARDIOTHORACIC SURGEONS OF KENTUCKY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-324-4745
Mailing Address - Street 1:PO BOX 2380
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2380
Mailing Address - Country:US
Mailing Address - Phone:606-326-9847
Mailing Address - Fax:606-324-3418
Practice Address - Street 1:613 23RD ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2878
Practice Address - Country:US
Practice Address - Phone:606-326-9847
Practice Address - Fax:606-324-3418
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENTUCKY HEART INSTITUTE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-02
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810015528Medicaid
KY7100085080Medicaid
OH2975786Medicaid
OH2975786Medicaid
KY00788Medicare PIN