Bluegrass Spine Care, PSC

Organization Active NPI Orthopaedic Surgery of the Spine Physician · Shelbyville, KY

NPI 1982755682 · NPPES record last updated Sep 26, 2018

Key facts

NPI
1982755682
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery of the Spine Physician 207XS0117X
License
32619 (KY)
Legal business name
BLUEGRASS SPINE CARE, PSC
Practice address
1741 Midland TRL
Shelbyville, KY 40065-1711
Phone
(502) 633-0192
Fax
(502) 633-4164
NPI assigned
Jan 16, 2007
Organization subpart
No

Authorized official

Name
Mark A Myers, MD
Title
Owner
Phone
(502) 633-0192

National Provider Directory

Locations

1023 New Moody Ln
Ste 202
Lagrange, KY 40031
Phone (502) 222-3452

1725 Harrodsburg Rd
#J
Lexington, KY 40504
Phone (859) 278-7226

709 Mount Eden Rd
Ste 2
Shelbyville, KY 40065
Phone (502) 633-0192

18 Village Plz
Shelbyville, KY 40065
Phone (859) 227-4835

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207XS0117X 32619 KY Yes

Addresses

Primary practice location

1741 Midland TRL
Shelbyville, KY 40065-1711

Mailing address

1741 Midland TRL
Shelbyville, KY 40065-1711
Phone (502) 633-0192

Other practice location 1

279 Kings Daughters Dr Ste 203
Frankfort, KY 40601-6562
Phone (502) 633-0192

Other practice location 2

1023 New Moody Ln Ste 202
LA Grange, KY 40031-9180
Phone (502) 633-0192

Other practice location 3

327 N Main St
Owenton, KY 40359-1409
Phone (502) 633-0192

Other identifiers

IdentifierTypeStateIssuer
1063266OtherKYPASSPORT
000802487OtherKYHUMANA
122601OtherKYCHA
2434349000OtherKYPASSPORT ADVANTAGE
5344332OtherKYAETNA
65930299MedicaidKY
5134693001OtherKYCIGNA

Other providers in Shelbyville, KY

All providers in Shelbyville, KY · Orthopaedic Surgery of the Spine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.