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General NPI Number Information
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NPI Number | 1871643650
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Entity Type | Organization
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Legal Business Name | FLYNN AND PETROSKY PSC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 340 BOGLE ST SUITE 104
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City | SOMERSET
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State | KY
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Zip | 42503-2892
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Country | US
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Telephone | 606-677-9250
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Fax |
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Provider Business Mailing Address
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Address Line | 340 BOGLE ST SUITE 104
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City | SOMERSET
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State | KY
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Zip | 42503-2892
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Country | US
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Telephone | 606-677-9250
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SUSAN J PETROSKY
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Credential | M.D.
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Telephone | 606-677-9250
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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 |
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