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General NPI Number Information
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NPI Number | 1386768604
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY OBGYN OF WESTERN KENTUCKY PSC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 2605 KENTUCKY AVE SUITE 103
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City | PADUCAH
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State | KY
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Zip | 42003-3800
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Country | US
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Telephone | 270-444-9199
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Fax | 270-444-9299
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Provider Business Mailing Address
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Address Line | 2605 KENTUCKY AVE SUITE 103
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City | PADUCAH
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State | KY
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Zip | 42003-3800
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Country | US
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Telephone | 270-444-9199
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Fax | 270-444-9299
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Authorized Official
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Title or Position | PRESIDENT,PHYSICIAN
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Name | DR. SUSAN MUELLER
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Credential | M.D.
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Telephone | 270-444-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 37833
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 37833
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License Number State | KY
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