Healthcare Provider Details

I. General information

NPI: 1013113745
Provider Name (Legal Business Name): STEVEN LEE THORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737B NORTH DRIVE
HOPKINSVILLE KY
42240
US

IV. Provider business mailing address

PO BOX 614
HOPKINSVILLE KY
42241-0614
US

V. Phone/Fax

Practice location:
  • Phone: 270-890-1780
  • Fax: 270-890-1789
Mailing address:
  • Phone: 270-886-2205
  • Fax: 270-886-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number40996
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: