PHYSICIAN SERVICES PSC

Provider Demographics

• NPI: 1558334466
• Name: PHYSICIAN SERVICES PSC
• Entity Type: Organization
• Organization Name: PHYSICIAN SERVICES PSC
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - Prefix: DR
• Authorized Official - First Name: ROBERT
• Authorized Official - Middle Name: E
• Authorized Official - Last Name: WINDSOR
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 859-252-6500
• Mailing Address - Street 1: 1713 NICHOLASVILLE RD
• Mailing Address - City: LEXINGTON
• Mailing Address - State: KY
• Mailing Address - Zip Code: 40503-1403
• Mailing Address - Country: US
• Mailing Address - Phone: 859-252-6500
• Mailing Address - Fax: 859-224-0094
• Practice Address - Street 1: 1721 NICHOLASVILLE RD
• Practice Address - City: LEXINGTON
• Practice Address - State: KY
• Practice Address - Zip Code: 40503-1428
• Practice Address - Country: US
• Practice Address - Phone: 859-252-6500
• Practice Address - Fax: 859-252-3073
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-02-10
• Last Update Date: 2013-08-12

Provider Licenses

State	License ID	Taxonomies
		207T00000X, 2084P0800X, 2085N0700X, 208VP0000X, 332B00000X, 332BC3200X, 332BN1400X, 363A00000X, 363AM0700X, 363AS0400X, 363L00000X, 363LA2200X, 363LX0106X
KY		2081P2900X, 208VP0014X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	208VP0000X	Allopathic & Osteopathic Physicians	Pain Medicine	Pain Medicine	Group - Multi-Specialty
No	207T00000X	Allopathic & Osteopathic Physicians	Neurological Surgery		Group - Multi-Specialty
No	2081P2900X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation	Pain Medicine	Group - Multi-Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	2085N0700X	Allopathic & Osteopathic Physicians	Radiology	Neuroradiology	Group - Multi-Specialty
No	208VP0014X	Allopathic & Osteopathic Physicians	Pain Medicine	Interventional Pain Medicine	Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	332BC3200X	Suppliers	Durable Medical Equipment & Medical Supplies	Customized Equipment	Group - Multi-Specialty
No	332BN1400X	Suppliers	Durable Medical Equipment & Medical Supplies	Nursing Facility Supplies	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Medical	Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Adult Health	Group - Multi-Specialty
No	363LX0106X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Occupational Health	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
KY	7100241280	Medicaid
KY	7100246380	Medicaid
KY	CD2933	Other	RAILROAD MCARE
KY	3810003494	Other	WV MEDICAID
KY	7100241170	Medicaid
KY	7100244620	Medicaid
KY	65926552	Medicaid
KY	7100243230	Medicaid
KY	2472800	Other	OHIO MEDICAID
KY	7100241790	Medicaid
KY	90102344	Medicaid
KY	7100243230	Medicaid
KY	7100244620	Medicaid