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General NPI Number Information
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NPI Number | 1861836322
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Entity Type | Organization
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Legal Business Name | DRAKES CREEK EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 270-793-2185
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Fax | 270-793-2055
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Provider Business Mailing Address
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Address Line | PO BOX 37931
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City | PHILADELPHIA
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State | PA
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Zip | 19101-0531
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KAREN VAUGHN
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Credential |
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Telephone | 404-450-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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