Basic Information
| Provider Information | |||||||||
| NPI: | 1790860179 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABRAMSON ANESTHESIOLOGY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4935 STATE ROUTE 303 | ||||||||
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| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420667218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736865550 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1029 MEDICAL CENTER CIR | ||||||||
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| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420661189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702514100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ABRAMSON | ||||||||
| AuthorizedOfficialFirstName: | MARC | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5736865550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | KY | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 367500000X | KY | X | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 65945081 | 05 | KY | MEDICAID | 000000355010 | 01 | KY | GROUP BCBS | OTHER |