Healthcare Provider Details

I. General information

NPI: 1134427958
Provider Name (Legal Business Name): ROBERT B COUTANT MD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 BURLEW BLVD STE C
OWENSBORO KY
42303-1799
US

IV. Provider business mailing address

1003 BURLEW BLVD STE C
OWENSBORO KY
42303-1799
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-6848
  • Fax: 270-685-4197
Mailing address:
  • Phone: 270-683-6848
  • Fax: 270-685-4197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number25509
License Number StateKY

VIII. Authorized Official

Name: DR. ROBERT B COUTNR
Title or Position: PRESIDENT
Credential: MD
Phone: 270-683-6848