Basic Information
| Provider Information | |||||||||
| NPI: | 1003866146 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA SERVICES OF KENTUCKY, PLLC | ||||||||
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| OtherOrganizationName: | ORA, PLLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 S FLOYD ST | ||||||||
| Address2: | SUITE 407 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026292880 | ||||||||
| FaxNumber: | 5026292879 | ||||||||
| Practice Location | |||||||||
| Address1: | 4001 DUTCHMANS LN | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026292880 | ||||||||
| FaxNumber: | 5026292879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 05/26/2016 | ||||||||
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| AuthorizedOfficialLastName: | JUNEJA | ||||||||
| AuthorizedOfficialFirstName: | MUSHTAQUE | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5026292880 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.