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NPI Code Detail

MEDICARE: SANDRA L FOOSHEE PA

MEDICARE: SANDRA L FOOSHEE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianPA708KY
2363AM0700XMedical Physician AssistantKY PA # 708KY
3363A00000XPhysician AssistantPA708KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20647603OTHERKYMEDICARE # WHILE WITH TEAM HEALTH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033183215
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA L FOOSHEE PA
Provider Business Mailing Address
First Line : PO BOX 23229
Second Line :
City : OWENSBORO
State : KY
Zip : 42304-3229
Country : US
Telephone Number : 270-688-1330
Fax Number :
Provider Business Practice Location Address
First Line : 1201 PLEASANT VALLEY RD
Second Line :
City : OWENSBORO
State : KY
Zip : 42303-9811
Country : US
Telephone Number : 270-417-5911
Fax Number : 270-417-6497
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 11/22/2021

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1201 PLEASANT VALLEY RD
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Directions to “ SANDRA L FOOSHEE PA” Practice Location

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