University Surgical Associates, PSC

Organization Active NPI Surgery Physician · Louisville, KY

NPI 1609847367 · NPPES record last updated Dec 21, 2011

Key facts

NPI
1609847367
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
UNIVERSITY SURGICAL ASSOCIATES, PSC
Practice address
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone
(502) 583-8303
Fax
(502) 584-0302
NPI assigned
Jan 31, 2006
Organization subpart
No

Authorized official

Name
Mr. Timothy D. Crockett, CEO
Title
Ceo
Phone
(502) 583-8303

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 94

National Provider Directory

Tax ID family
University Surgical Associates PSC (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Y00000X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X Yes
Plastic and Reconstructive Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2086S0122X
Surgical Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2086X0206X
Colon & Rectal Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208C00000X
Audiologist
Group: 193200000X MULTI-SPECIALTY GROUP
231H00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X
Surgical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363AS0400X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700

Mailing address

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303

Other identifiers

IdentifierTypeStateIssuer
100001110AMedicaidIN
1051066OtherKYPASSPORT
65900946MedicaidKY

Other providers in Louisville, KY

All providers in Louisville, KY · Surgery Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.