Provider Demographics
NPI:1639374465
Name:NEUROSURGICAL ASSOCIATES OF WESTERN KENTUCKY, PSC
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES OF WESTERN KENTUCKY, PSC
Other - Org Name:PHYSICIANS MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-441-4430
Mailing Address - Street 1:225 MEDICAL CENTER DRIVE, SUITE 401
Mailing Address - Street 2:P.O. BOX 7843
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7843
Mailing Address - Country:US
Mailing Address - Phone:270-441-4430
Mailing Address - Fax:
Practice Address - Street 1:225 MEDICAL CENTER DR STE 401
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207T00000X, 363AS0400X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty