Provider Demographics
NPI:1639402001
Name:ORTHO KENTUCKY PLLC
Entity Type:Organization
Organization Name:ORTHO KENTUCKY PLLC
Other - Org Name:KENTUCKY ORTHOPAEDIC AND HAND SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DEGNORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-3481
Mailing Address - Street 1:1780 NICHOLASVILLE RD
Mailing Address - Street 2:STE 501
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1400
Mailing Address - Country:US
Mailing Address - Phone:859-278-3481
Mailing Address - Fax:859-277-7365
Practice Address - Street 1:1780 NICHOLASVILLE RD
Practice Address - Street 2:STE 501
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1400
Practice Address - Country:US
Practice Address - Phone:859-278-3481
Practice Address - Fax:859-277-7365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHO KENTUCKY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-16
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6406770001Medicare NSC