Use this form to request a new UK HealthCare provider profile or to update an existing profile. UK HealthCare is primarily located throughout Kentucky, USA. Who is completing this form? Department contact person Provider Information Full Legal Name First Name Middle Name or Initial Last Name Suffix Degree ex: MD, PhD, FASHA Preferred Name Are you updating your existing profile? - Select -YesNo, I am submitting info for a new profile. Linkblue ID NPI Number Faculty Titles Faculty Appointment / Rank Degrees example: MD, University of Kentucky, College of Medicine Fellowships Residency Gender Languages Spoken (Other than English) Awards Current Certifications or Special Training example: American Board of Pediatrics, Surgery Curriculum Vitae One file only.256 MB limit.Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods. Biography Can patients request an appointment with you directly? Yes No, physician referrals only I do not accept appointments or referrals Are you seeing new patients at this time? Yes No Your Personal Philosophy Answers to the questions below may encourage a patient to request an appointment with you. Why did you choose to get into your field of medicine? What is your philosophy on patient care? Why should a patient choose you? What are you most interested in outside of practicing medicine? Tell us something surprising/interesting/fun that patients would be surprised to know. Practice Areas / Teams? AcupunctureAcute Care Surgery, Trauma and Surgical Critical CareAdvanced EndoscopyAnatomic & Clinical PathologyCardiovascular SurgeryCertified Diabetes EducatorCommunity OncologyCritical Care NephrologyCriticl Care AnesthesiologyCytopathologyDentistry - CosmeticFamily MedicineForensic PathologyGeneral EndoscopyGeneral NephrologyHematopathologyHepatologyImmunopathologyMultiple SclerosisNuclear RadiologyOpticianOral PathologyOral SurgeryPelvic Floor Physical TherapyPharmacyPhysical and Occupational TherapyRadiologyRegistered DieticianRehabilitation ServicesSurgerySurgical PathologyThoracic SurgeryVascular NeurologyAdolescent MedicineAdult Congenital Heart DiseaseAdvanced Cardiovascular ImagingAllergyAllergy and ImmunologyALS - Amyotrophic Lateral SclerosisAnesthesiology-Acute Pain and Regional Anesthesia-Cardiothoracic Anesthesia-Critical Care Anesthesia-General Anesthesia-Neuroanesthesia-Obstetric Anesthesia-Preoperative Anesthesia AssessmentAneurysms and Arteriovenous DisordersAnterior Skull Base SurgeryAudiologyBone Cancer TeamBotulinum ProgramBrain Cancer Team-Neuro-oncologyBreast Cancer TeamBreastfeedingCarcinoid and Neuroendocrine Cancer TeamCardiac Catheterization and InterventionsCardiac Intensive CareCardiac Rehabilitation and WellnessCardiothoracic SurgeryCardiovascular GeneticsCardiovascular MedicineClinical CardiologyColorectal SurgeryComprehensive Epilepsy ProgramCosmetic Surgery AssociatesCounselingCritical Care PharmacyCystic FibrosisDentistry - AdultDentistry - EndodonticsDentistry - Oral and Maxillofacial PathologyDentistry - Oral and Maxillofacial SurgeryDentistry - Oral Diagnosis Oral MedicineDentistry - Orofacial PainDentistry - OrthodonticsDentistry - PediatricDentistry - PeriodontologyDentistry - ProsthodonticsDentistry - RestorativeDermatologyDevelopmental PediatricsDiabetes TreatmentDigestive Diseases and Nutrition (Gastroenterologists)Ear, Nose and Throat (Otolaryngology)Emergency Medicine-Medical ToxicologyEndocrine SurgeryEndocrinologyFacial Plastic and Reconstructive SurgeryFamily and Community MedicineFemale Pelvic Medicine and Reconstructive SurgeryFoot and Ankle SurgeryGamma Knife® Radiosurgery CenterGastrointestinal and Colorectal Cancer TeamGastrointestinal and Minimally Invasive SurgeryGeneral Internal Medicine and GeriatricsGeneral OrthopaedicsGeneral SurgeryGenetic CounselingGenitourinary and Prostate Cancer TeamGynecologic Cancer TeamHand Surgery (Orthopaedic)-Hand Surgery (Plastic Surgery)Head and Neck Cancer TeamHead and Neck SurgeryHeadache and PainHeart Attack Emergency CareHeart Failure, MCS and Transplant TeamHeart Rhythm ProgramHematology and Blood Marrow Transplantation TeamHip & Knee Replacement TeamHospital MedicineInfectious DiseasesInternational AdoptionLipid ManagementLiver Cancer TeamLiving Donor Kidney TransplantLung and Thoracic Cancer TeamMed-Peds ClinicMedical OncologyMelanoma (Skin Cancer) TeamMemory and Aging ProgramMenopause and Mid-life HealthMovement DisordersMultidisciplinary ConcussionMusculoskeletal OncologyNeonatologyNephrology, Bone and Mineral MetabolismNeuro-oncologyNeuro-ophthalmologyNeurologyNeuromuscular DiseaseNeuropsychologyNeurorehabilitationNeurosurgeryNeurotoxicologyNICU Graduate ProgramObstetrics and GynecologyObstetrics and Gynecology Maternal-Fetal MedicineObstetrics and Gynecology Pelvic Floor DisordersOccupational Medicine and Environmental HealthPediatric Occupational TherapyOphthalmic GeneticsOphthalmology (Advanced Eye Care)Orthopaedic SurgeryOrthopaedic TraumaPain Management AnesthesiaPalliative CarePancreas Cancer Team-Hepatobiliary / Pancreatic Cancer TeamPathology and Laboratory MedicinePediatric and Adolescent GynecologyPediatric AnesthesiaPediatric Cancer TeamPediatric CardiologyPediatric Cardiothoracic SurgeryPediatric Congenital Heart DiseasePediatric Critical CarePediatric Ear Nose and Throat (Otolaryngology)Pediatric ElectrophysiologyPediatric Emergency MedicinePediatric EndocrinologyPediatric Forensic MedicinePediatric GastroenterologyPediatric General and Thoracic SurgeryPediatric Genetics and MetabolismPediatric Hematology and Oncology TeamPediatric High BMI ClinicPediatric Hospital MedicinePediatric Infectious DiseasesPediatric Interventional CardiologyPediatric Kidney Transplant TeamPediatric Long-Term Follow-up ClinicPediatric NephrologyPediatric NeurologyPediatric NeurosciencePediatric NeurosurgeryPediatric Ophthalmology (Advanced Eye Care)Pediatric Oral and Maxillofacial SurgeryPediatric OrthopaedicsPediatric Palliative CarePediatric Plastic SurgeryPediatric PulmonologyPediatric RheumatologyPediatric UrologyPediatric Vascular MalformationPeripheral Arterial DiseasePhysical Medicine and RehabilitationPituitary and Skull Base DisordersPlastic SurgeryPodiatryPrimary CarePrimary Care PediatricsPsychiatry-Addiction and Substance Abuse-Addiction Medicine-Forensic Psychiatry-Geriatric Psychiatry-Electroconvulsive Therapy (ECT)Psychiatry - Child and AdolescentPsychologyPulmonary Critical Care and Sleep MedicinePulmonary HypertensionRadiation OncologyRadiology - AbdominalRadiology - Cardiovascular and ThoracicRadiology - EmergencyRadiology - MusculoskeletalRadiology - NeuroradiologyRadiology - Nuclear Medicine and Molecular ImagingRadiology - PediatricRadiology - Vascular and InterventionalRadiology - Women'sRetinal DiseasesRheumatologyRhinologyRhinology and Paranasal Sinus DiseaseSarcoma TeamSinusSpecial Needs/Complex Care ClinicSpeech Language PathologySpine surgery-Neuro Spine Surgery-Orthopaedic Spine CareSports MedicineSports Primary CareSports RehabilitationStroke and Cerebrovascular DisordersStructural Heart ProgramSurgical OncologyTeam Blue Primary Care Clinic (UK HealthCare Plans only)Thyroid Cancer TeamTransfusion Medicine/Blood BankTransplant - HeartTransplant - HepatobiliaryTransplant - KidneyTransplant - LiverTransplant - LungTransplant - Mechanical Circulatory SupportTransplant - PancreasTransplant SurgeryUniversity Health Service (UK Students or UK Employees)UrologyUterine Fibroid ProgramVascular and Endovascular SurgeryVoice and Swallowing DisordersWell Woman ClinicWomen's Health - Primary CareWomen’s Heart HealthYoung Parents Program To select multiple practice areas, press and hold control (PC) or command (Mac) while making your selections. Conditions you treat Procedures you perform Practice Locations and Days You are at Each Location example: Pav G, First Floor, Room 123 - Thurs and Fridays Kentucky Clinic, Second Floor, Suite A - Mondays News / Events Include links to news articles, presentations or events where you are mentioned. Videos / Media Include links to videos or podcasts where you are featured.