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Contact Information

SOUTHERN KENTUCKY UROLOGY LLC
1325 ANDREA ST
SUITE 103
BOWLING GREEN, KY42104-5852
 Phone: 270-796-9191
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for SOUTHERN KENTUCKY UROLOGY LLC

NPI Number 1114962867
LBN Legal business name SOUTHERN KENTUCKY UROLOGY LLC
Authorized official CHUCK LOCKE - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/17/2006
Last updated 04/20/2008 - About 18 years ago
Identifiers
IN License # 01046326A
KY Medicaid 7100003160
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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