Basic Information
Provider Information
NPI: 1346240108
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENGLISH
FirstName: ROBERT
MiddleName: JUDD
NamePrefix: MR.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ENGLISH
OtherFirstName: ROBERT
OtherMiddleName: JUDD
OtherNamePrefix: MR.
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 5
Mailing Information
Address1: 800 ROSE STREET
Address2: DEPT OF ANESTHESIOLOGY CHANDLER MEDICAL CENTER
City: LEXINGTON
State: KY
PostalCode: 40536
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Practice Location
Address1: 800 ROSE STREET
Address2: DEPT OF ANESTHESIOLOGY CHANDLER MEDICAL CENTER
City: LEXINGTON
State: KY
PostalCode: 40536
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 07/22/2005
LastUpdateDate: 02/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X3005992KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
7400800405KY MEDICAID
363505005TN MEDICAID
407229701TNBCBS NUMBEROTHER
00994160505AL MEDICAID


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