Provider Demographics
NPI:1043356504
Name:HOLZAPFEL & LIED PLASTIC SURGERY CENTER PSC
Entity type:Organization
Organization Name:HOLZAPFEL & LIED PLASTIC SURGERY CENTER PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-331-9600
Mailing Address - Street 1:133 BARNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2500
Mailing Address - Country:US
Mailing Address - Phone:859-331-9600
Mailing Address - Fax:859-578-3321
Practice Address - Street 1:133 BARNWOOD DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-2500
Practice Address - Country:US
Practice Address - Phone:859-331-9600
Practice Address - Fax:859-578-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDE9245231Medicare PIN
KY2462Medicare PIN