Healthcare Provider Details

I. General information

NPI: 1235243288
Provider Name (Legal Business Name): CAROL HULSEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 SCHERM RD
OWENSBORO KY
42301-6052
US

IV. Provider business mailing address

7045 MASONVILLE HABIT RD
PHILPOT KY
42366-9105
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-1635
  • Fax:
Mailing address:
  • Phone: 270-729-2114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5618
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: