Kentucky Mso LLC

NPI #1568907798 in Georgetown, Kentucky

Provider Information

NPI Number: 1568907798
Entity Type: Organization
Organization Name: Kentucky Mso LLC
Primary Specialty: Pediatrics
Enumeration Date: Dec 26, 2016
Last Updated: Dec 26, 2016

Practice Location

Address: 196 BEVINS LN
Address 2: SUITE F
City: Georgetown
State: Kentucky
ZIP Code: 40324-8534
Phone: (502) 863-2818

Authorized Official

Name: SARA MILLER
Title: DIRECTOR
Phone: (615) 920-7514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Pediatrics	208000000X	Primary

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