Provider Demographics
NPI:1023074416
Name:KENTUCKY NEURO ASSOCIATES
Entity type:Organization
Organization Name:KENTUCKY NEURO ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-583-1697
Mailing Address - Street 1:210 E GRAY ST
Mailing Address - Street 2:SUITE 1106
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3900
Mailing Address - Country:US
Mailing Address - Phone:502-583-1697
Mailing Address - Fax:502-583-4085
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:SUITE 1106
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3900
Practice Address - Country:US
Practice Address - Phone:502-583-1697
Practice Address - Fax:502-583-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65922957Medicaid
KY2885Medicare ID - Type Unspecified