Provider Demographics
NPI:1497858385
Name:KENTUCKY SLEEP CLINIC, PSC
Entity type:Organization
Organization Name:KENTUCKY SLEEP CLINIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-435-1889
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:STE. 2M
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9466
Mailing Address - Country:US
Mailing Address - Phone:606-487-1818
Mailing Address - Fax:606-487-8448
Practice Address - Street 1:1911 NORTH HIGHWAY 15
Practice Address - Street 2:STE. A
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-435-1889
Practice Address - Fax:606-439-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65944837Medicaid