Provider Demographics
NPI:1538305461
Name:ASSOCIATES IN GENERAL SURGERY, PSC
Entity Type:Organization
Organization Name:ASSOCIATES IN GENERAL SURGERY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-583-5948
Mailing Address - Street 1:201 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:STE 902
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3841
Mailing Address - Country:US
Mailing Address - Phone:502-583-5948
Mailing Address - Fax:502-583-1904
Practice Address - Street 1:4601 MEDICAL PLAZA WAY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-9204
Practice Address - Country:US
Practice Address - Phone:812-284-6100
Practice Address - Fax:812-284-6137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATES IN GENERAL SURGERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-24
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26230Medicare PIN