Healthcare Provider Details

I. General information

NPI: 1134553902
Provider Name (Legal Business Name): SAINT JOSEPH HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 W 5TH ST STE 1
LONDON KY
40741-1688
US

IV. Provider business mailing address

1406 W 5TH ST STE 1
LONDON KY
40741-1688
US

V. Phone/Fax

Practice location:
  • Phone: 606-877-4579
  • Fax: 606-330-6711
Mailing address:
  • Phone: 606-877-4579
  • Fax: 606-330-6711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY SPITSER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 606-877-4579