Healthcare Provider Details
I. General information
NPI: 1144412479
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2007
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
471 KLUTEY PARK PLAZA DR
HENDERSON KY
42420-3347
US
IV. Provider business mailing address
PO BOX 638706
CINCINNATI OH
45263-8706
US
V. Phone/Fax
- Phone: 270-830-8032
- Fax: 270-830-8132
- Phone: 270-827-7558
- Fax: 270-827-7530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BENNY
J
NOLEN
Title or Position: CEO
Credential:
Phone: 270-827-7500