Organization · NPI-2
Ladies Clinic , Psc
Obstetrics & Gynecology, Gynecology · Somerset, KY
NPI number1902928898
StatusActive
Last updated in NPPESMar 12, 2009
Details
- NPI
- 1902928898
- Entity type
- Organization (NPI-2)
- Legal business name
- Ladies Clinic , Psc
- Organization subpart
- No
- Enumeration date
- Apr 4, 2007
- Last updated
- Mar 12, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207VG0400X | Obstetrics & Gynecology, Gynecology | 23151 | KY | Yes |
| 363LW0102X | Nurse Practitioner, Women's Health | 1358P | KY | |
| 363LW0102X | Nurse Practitioner, Women's Health | 5888P | KY |
Practice location
347 Bogle St Ste ASomerset, KY 42503-2873
Phone 606-679-7353
Mailing address
347 Bogle St Ste ASomerset, KY 42503-2873
Phone 606-679-7353
Authorized official
Dennis R Faulkner
President
6066797353
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