Provider Demographics
NPI:1962647297
Name:ARTHRITIS AND OSTEOPOROSIS CENTER OF KENTUCKY PLLC
Entity Type:Organization
Organization Name:ARTHRITIS AND OSTEOPOROSIS CENTER OF KENTUCKY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANSOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-623-5500
Mailing Address - Street 1:2130 LEXINGTON RD STE A-B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7923
Mailing Address - Country:US
Mailing Address - Phone:859-623-5500
Mailing Address - Fax:833-249-5207
Practice Address - Street 1:2130 LEXINGTON RD STE A-B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7923
Practice Address - Country:US
Practice Address - Phone:859-623-5500
Practice Address - Fax:833-249-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
786409OtherAETNA PIN#
KY000000598640OtherANTHEM GROUP #
KY000000598640OtherANTHEM GROUP #