Healthcare Provider Details

I. General information

NPI: 1205834918
Provider Name (Legal Business Name): JOHN ERIC VOAKES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICK VOAKES M.D.

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 7TH AVE
BOWLING GREEN KY
42101-6921
US

IV. Provider business mailing address

615 7TH AVE P.O. BOX 1177
BOWLING GREEN KY
42101-6921
US

V. Phone/Fax

Practice location:
  • Phone: 270-783-3573
  • Fax:
Mailing address:
  • Phone: 270-783-3573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20959
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: