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General NPI Number Information
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NPI Number | 1679619811
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Entity Type | Organization
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Legal Business Name | PHYSICIAN MANAGEMENT SERVICES PSC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 1573 HWY 259N
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City | BROWNSVILLE
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State | KY
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Zip | 42210
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Country | US
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Telephone | 270-597-2168
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Fax | 270-597-2033
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Provider Business Mailing Address
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Address Line | PO BOX 90039
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City | BOWLING GREEN
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State | KY
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Zip | 42102-9039
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Country | US
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Telephone | 270-796-8800
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Fax | 270-796-9328
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Authorized Official
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Title or Position | SECRETARY
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Name | KALIDAS G SAHETYA
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Credential | MD
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Telephone | 270-796-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 900024
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License Number State | KY
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