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General NPI Number Information
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NPI Number | 1366699811
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Entity Type | Organization
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Legal Business Name | CALDWELL COUNTY HOSPITAL, INC
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 323 S JEFFERSON ST UNIT C
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City | PRINCETON
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State | KY
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Zip | 42445-2100
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Country | US
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Telephone | 270-744-9600
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Fax | 270-744-0834
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Provider Business Mailing Address
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Address Line | PO BOX 9150
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City | PADUCAH
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State | KY
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Zip | 42002-9150
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Country | US
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Telephone | 270-744-9600
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Fax | 270-744-0834
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | LINDA DERR
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Credential |
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Telephone | 270-744-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41705
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License Number State | KY
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