| NPI | 1497088090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY K RUDD Billing Specialist 270-827-4596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 40961) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |