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2603 Kentucky Ave Suite 304 Paducah KY 42003-3814 | |
| (270) 415-4800 | |
| (270) 415-4801 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2603 Kentucky Ave, Paducah, Kentucky |
| Authorized Official Name and Position | Jennifer A Townsend (REGIONAL EXECUTIVE DIR OF OPERATION) |
| Authorized Official Contact | 2704157646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 7309 Paducah KY 42002-7309 Ph: (270) 744-9600 | 2603 Kentucky Ave Suite 304 Paducah KY 42003-3814 Ph: (270) 415-4800 |
| NPI Number | 1568699478 |
|---|---|
| Provider Enumeration Date | 06/18/2009 |
| Last Update Date | 09/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568699478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 44538 (Kentucky) | Primary |
| 364SA2200X | Clinical Nurse Specialist - Adult Health | 3006220 (Kentucky) | Secondary |
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