Provider Demographics
NPI:1821130741
Name:UNIVERSITY OF KENTUCKY
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY
Other - Org Name:UNIVERSITY OF KENTUCKY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXEC VP FOR HEALTH AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-323-5126
Mailing Address - Street 1:2317 ALUMNI PARK PLZ STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4291
Mailing Address - Country:US
Mailing Address - Phone:859-257-9521
Mailing Address - Fax:859-257-1773
Practice Address - Street 1:310 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-3008
Practice Address - Country:US
Practice Address - Phone:859-226-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF KENTUCKY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-14
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100121273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9200005800Medicaid
KY9200005800Medicaid