Healthcare Provider Details

I. General information

NPI: 1184825101
Provider Name (Legal Business Name): SHIRLEY K CATRON M D PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 BURKESVILLE RD
ALBANY KY
42602-1654
US

IV. Provider business mailing address

701 BURKESVILLE RD
ALBANY KY
42602-1654
US

V. Phone/Fax

Practice location:
  • Phone: 606-387-0675
  • Fax: 606-387-3149
Mailing address:
  • Phone: 606-387-0675
  • Fax: 606-387-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38599
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number38599
License Number StateKY

VIII. Authorized Official

Name: DR. SHIRLEY K. CATRON
Title or Position: OWNER
Credential: M.D.
Phone: 606-387-0675