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General NPI Number Information
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NPI Number | 1467502534
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Entity Type | Organization
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Legal Business Name | EWING-EAR, NOSE & THROAT
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 105 GREENBRIAR DR SUITE A
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9617
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Country | US
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Telephone | 270-465-3595
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Fax | 270-789-2044
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Provider Business Mailing Address
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Address Line | 105 GREENBRIAR DR SUITE A
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9617
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Country | US
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Telephone | 270-465-3595
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Fax | 270-789-2044
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES E EWING
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Credential | MD
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Telephone | 270-465-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 29697
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License Number State | KY
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