| NPI | 1639131246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LASHAEY THOMPSON Office Manager 270-251-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 41420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005111) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: KY 3004998) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 30255) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2015-01-12 |