Provider Demographics
NPI:1861992885
Name:WEST KENTUCKY ANESTHESIA ASSOCIATES
Entity type:Organization
Organization Name:WEST KENTUCKY ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BUGG
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:423-639-0941
Mailing Address - Street 1:PO BOX 7289
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7289
Mailing Address - Country:US
Mailing Address - Phone:423-639-0941
Mailing Address - Fax:423-638-3401
Practice Address - Street 1:201 HUNTING CRK
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-8762
Practice Address - Country:US
Practice Address - Phone:423-639-0941
Practice Address - Fax:423-638-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty