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General NPI Number Information
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NPI Number | 1093331274
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Entity Type | Organization
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Legal Business Name | OWENSBORO SURGICAL PLLC
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 2200 E PARRISH AVE BLDG C
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City | OWENSBORO
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State | KY
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Zip | 42303-1449
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Country | US
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Telephone | 270-541-1410
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Fax | 270-541-1412
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Provider Business Mailing Address
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Address Line | PO BOX 34770
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City | BELFAST
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State | ME
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Zip | 04915-0625
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | DR. MICHAEL RAY WEST JR.
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Credential | MD
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Telephone | 502-643-9378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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