Healthcare Provider Details
I. General information
NPI: 1932303294
Provider Name (Legal Business Name): BALLARD COUNTY MEDICAL CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 S 4TH ST
BARLOW KY
42024
US
IV. Provider business mailing address
PO BOX 7287
PADUCAH KY
42002-7287
US
V. Phone/Fax
- Phone: 270-534-8999
- Fax: 270-534-1670
- Phone: 270-534-8999
- Fax: 270-534-1670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 29194 |
| License Number State | KY |
VIII. Authorized Official
Name: DR.
JOSEPH
H
HARPOLE
JR.
Title or Position: OWNER
Credential: MD
Phone: 270-534-8999