Provider Demographics
NPI:1801193057
Name:OUTPATIENT ANESTHESIA OF KENTUCKY, PLLC
Entity type:Organization
Organization Name:OUTPATIENT ANESTHESIA OF KENTUCKY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-765-4275
Mailing Address - Street 1:3170 HUTCHERSON LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6951
Mailing Address - Country:US
Mailing Address - Phone:270-765-4275
Mailing Address - Fax:
Practice Address - Street 1:3170 HUTCHERSON LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-6951
Practice Address - Country:US
Practice Address - Phone:270-765-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26059208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty