Provider Demographics
NPI:1801902341
Name:WEST KENTUCKY SURGICAL, INC
Entity type:Organization
Organization Name:WEST KENTUCKY SURGICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-753-2444
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 401E
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-753-2444
Mailing Address - Fax:270-767-3644
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 401E
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-753-2444
Practice Address - Fax:270-767-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCB3611OtherMEDICARE RAILROAD
KY65933855Medicaid
KY65933855Medicaid
KY1598767998OtherNPI DOCTOR
KY65933855Medicaid
KY=========001OtherTRICARE
KY1568457398OtherNPI
KY5921Medicare ID - Type Unspecified