Healthcare Provider Details

I. General information

NPI: 1659331049
Provider Name (Legal Business Name): DAVID SCOTT OVERSTREET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PONDER CT STE 104
DANVILLE KY
40422-9050
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-4216
  • Fax: 859-238-9760
Mailing address:
  • Phone: 859-236-4216
  • Fax: 859-238-9760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number27420
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: