| NPI | 1811156458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA DERR Provider Enrollment Specialist 270-744-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 21441) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-13 |