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General NPI Number Information
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NPI Number | 1548355688
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Entity Type | Organization
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Legal Business Name | UROLOGY PARTNERS OF WESTERN KY, PSC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 44 MCCOY AVE
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City | MADISONVILLE
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State | KY
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Zip | 42431-2867
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Country | US
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Telephone | 270-825-0020
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Fax | 270-643-0082
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Provider Business Mailing Address
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Address Line | PO BOX 1062
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City | HENDERSON
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State | KY
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Zip | 42419-1062
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Country | US
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Telephone | 270-827-2915
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Fax | 270-643-0082
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES M FELLOWS
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Credential | MD
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Telephone | 270-827-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 24878
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License Number State | KY
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