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General NPI Number Information
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NPI Number | 1811270010
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Entity Type | Organization
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Legal Business Name | KINGS DAUGHTERS MEDICAL SPECIALTIES INC
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 399 DIEDERICH BLVD
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-326-0470
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Fax | 606-326-0474
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-408-4000
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Fax | 606-326-0474
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Authorized Official
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Title or Position | VICE PRESIDENT - FINANCE
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Name | MR. PAUL L MCDOWELL
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Credential |
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Telephone | 606-408-4000
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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 |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 700229
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License Number State | KY
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