MEDICARE: ELIZABETHTOWN HEMATOLOGY-ONCOLOGY PLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2084N0400X	Neurology Physician
2	207RR0500X	Rheumatology Physician
3	207RH0003X	Hematology & Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1050030	OTHER	KY	PASSPORT

General Provider Information

NPI Number	:	1730161688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETHTOWN HEMATOLOGY-ONCOLOGY PLC

Provider Business Mailing Address
First Line	:	1107 WOODLAND DR
Second Line	:	SUITE 105
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-2789
Country	:	US
Telephone Number	:	270-769-6665
Fax Number	:	270-769-0322

Provider Business Practice Location Address
First Line	:	1107 WOODLAND DR
Second Line	:	SUITE 105
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-2789
Country	:	US
Telephone Number	:	270-769-6665
Fax Number	:	270-769-0322

Authorized Official
Title or Position	:	OFFICE MANGER
Name	:	MR. NAWEED BEG
Credential	:
Telephone Number	:	270-769-6665

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	04/09/2015

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Directions to “ELIZABETHTOWN HEMATOLOGY-ONCOLOGY PLC ” Practice Location

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