| Neurology Group Of Paducah, Pllc | |
|
2603 Kentucky Ave Suite 402 Paducah KY 42003-3814 | |
| (270) 443-2830 | |
| (270) 443-7108 |
| Full Name | Neurology Group Of Paducah, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2603 Kentucky Ave, Paducah, Kentucky |
| Authorized Official Name and Position | Van M Woeltz (OWNER) |
| Authorized Official Contact | 2704432830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Group Of Paducah, Pllc 2603 Kentucky Ave Suite 402 Paducah KY 42003-3814 Ph: (270) 443-2830 | Neurology Group Of Paducah, Pllc 2603 Kentucky Ave Suite 402 Paducah KY 42003-3814 Ph: (270) 443-2830 |
| NPI Number | 1790893964 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 03/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790893964 | NPI | - | NPPES |
| 1391 | Other | IL | NEUROLOGY GROUP PTAN |
| 65939647 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 87743 (Kentucky) | Primary |
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