Healthcare Provider Details

I. General information

NPI: 1962084624
Provider Name (Legal Business Name): ALYSSA HOUNSHELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSSA COLE

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 ROY CAMPBELL DR
HAZARD KY
41701-9407
US

IV. Provider business mailing address

82 ALYSSA LN
JACKSON KY
41339-8833
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-1316
  • Fax: 606-439-8457
Mailing address:
  • Phone: 606-568-8198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTP247
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: