Provider Demographics
NPI:1558497586
Name:CANH JEFF V. VO, D. O., PSC
Entity Type:Organization
Organization Name:CANH JEFF V. VO, D. O., PSC
Other - Org Name:BLUEGRASS WOMEN'S HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CANH JEFF
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:270-765-3301
Mailing Address - Street 1:551D WESTPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2950
Mailing Address - Country:US
Mailing Address - Phone:270-765-3301
Mailing Address - Fax:270-765-3928
Practice Address - Street 1:551 WESTPORT RD STE D
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2950
Practice Address - Country:US
Practice Address - Phone:270-765-3301
Practice Address - Fax:270-765-3928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1144533Medicaid
KY1144533Medicaid