Healthcare Provider Details

I. General information

NPI: 1730315789
Provider Name (Legal Business Name): PAM COMBS MD CONSULTING SERVICES, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 11/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CLINIC DR
PARIS KY
40361-2166
US

IV. Provider business mailing address

24 CLINIC DR
PARIS KY
40361-2166
US

V. Phone/Fax

Practice location:
  • Phone: 859-987-0302
  • Fax: 859-987-0358
Mailing address:
  • Phone: 859-987-0302
  • Fax: 859-987-0358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: PAM COMBS
Title or Position: MD/OWNER
Credential: M.D.
Phone: 859-987-0302