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General NPI Number Information
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NPI Number | 1346239761
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Entity Type | Organization
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Legal Business Name | J P STULC PSC
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 444 MAIN STREET
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City | MADISONVILLE
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State | KY
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Zip | 42431
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Country | US
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Telephone | 812-471-1591
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Fax | 812-471-6650
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Provider Business Mailing Address
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Address Line | PO BOX 717
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City | EVANSVILLE
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State | IN
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Zip | 47705-0717
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Country | US
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Telephone | 812-471-1591
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Fax | 812-471-6650
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAROSLAV P STULC
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Credential | M.D.
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Telephone | 812-471-1591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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