Provider Demographics
NPI:1700852340
Name:PHYSICIAN SERVICES, PSC
Entity Type:Organization
Organization Name:PHYSICIAN SERVICES, PSC
Other - Org Name:KENTUCKY PAIN CARE & BLUEGRASS HIGH SPEED MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF TIN/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-252-6500
Mailing Address - Street 1:189 WEST HIGHWAY 192 BYPASS
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-2428
Mailing Address - Country:US
Mailing Address - Phone:859-252-6500
Mailing Address - Fax:606-877-5454
Practice Address - Street 1:189 WEST HIGHWAY 192 BYPASS
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-2428
Practice Address - Country:US
Practice Address - Phone:859-252-6500
Practice Address - Fax:606-877-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2472800OtherOHIO MEDICAID
KYCD2933OtherRR MEDICARE
KY3810003494OtherWV MEDICAID
KY65926552Medicaid