Healthcare Provider Details

I. General information

NPI: 1376564963
Provider Name (Legal Business Name): SEAN M DENTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 HOSPITAL DR
MADISONVILLE KY
42431-1644
US

IV. Provider business mailing address

PO BOX 1558
SHELBYVILLE KY
40066-1558
US

V. Phone/Fax

Practice location:
  • Phone: 270-326-4520
  • Fax: 270-875-5538
Mailing address:
  • Phone: 502-386-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number40983
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: