Provider Demographics
NPI:1346411188
Name:KENTUCKIANA THORACIC & VASCULAR SURGERY. P.C/
Entity Type:Organization
Organization Name:KENTUCKIANA THORACIC & VASCULAR SURGERY. P.C/
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCO
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:REA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-949-8355
Mailing Address - Street 1:1919 STATE ST
Mailing Address - Street 2:SUITE 364
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4929
Mailing Address - Country:US
Mailing Address - Phone:812-949-8355
Mailing Address - Fax:812-949-4941
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:SUITE 364
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4929
Practice Address - Country:US
Practice Address - Phone:812-949-8355
Practice Address - Fax:812-949-4941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27240208G00000X
IN04712208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200897280 AMedicaid
KY64272404Medicaid
000000562595OtherBLUE CROSS IN&KY