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General NPI Number Information
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NPI Number | 1013919091
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Entity Type | Organization
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Legal Business Name | PULMONARY ASSOCIATES OF OWENSBORO PSC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 1000 BRECKENRIDGE ST SUITE 300
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City | OWENSBORO
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State | KY
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Zip | 42303-0839
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Country | US
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Telephone | 270-926-8810
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Fax | 270-926-7955
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Provider Business Mailing Address
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Address Line | PO BOX 1875
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City | OWENSBORO
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State | KY
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Zip | 42302-1875
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Country | US
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Telephone | 270-926-8810
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Fax | 270-926-7955
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM M O'BRYAN
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Credential | MD
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Telephone | 270-926-8810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | KY
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