Healthcare Provider Details

I. General information

NPI: 1225016801
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 NORTH ELM ST
HENDERSON KY
42420
US

IV. Provider business mailing address

PO BOX 638704
CINCINNATI OH
45263-8704
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-7700
  • Fax: 270-827-7469
Mailing address:
  • Phone: 270-827-7468
  • Fax: 270-831-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE JENKINS
Title or Position: VP
Credential:
Phone: 270-827-7118