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General NPI Number Information
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NPI Number | 1093138323
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Entity Type | Organization
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Legal Business Name | OWENSBORO DERMATOLOGY ASSOCIATES
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Dates
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Enumeration Date | 01/22/2014
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 2821 NEW HARTFORD RD
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City | OWENSBORO
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State | KY
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Zip | 42303-1320
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Country | US
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Telephone | 270-685-5777
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Fax | 270-685-0190
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Provider Business Mailing Address
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Address Line | 2821 NEW HARTFORD RD
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City | OWENSBORO
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State | KY
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Zip | 42303-1320
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Country | US
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Telephone | 270-685-5777
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Fax | 270-685-0190
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Authorized Official
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Title or Position | CREDENTIALING
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Name | JULIA ALVEY
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Credential |
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Telephone | 270-852-3893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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