Provider Demographics
NPI:1558954776
Name:KENTUCKY HOSPITALIST GROUP, PLLC
Entity Type:Organization
Organization Name:KENTUCKY HOSPITALIST GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-576-9895
Mailing Address - Street 1:3117 AYLESBURY CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2372
Mailing Address - Country:US
Mailing Address - Phone:859-948-8430
Mailing Address - Fax:859-744-3095
Practice Address - Street 1:3117 AYLESBURY CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2372
Practice Address - Country:US
Practice Address - Phone:859-948-8430
Practice Address - Fax:859-744-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty