# SLEEP SOURCE KENTUCKY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kentucky Sleep Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174771018
- **Authorized official:** MR. MARK SEXTON RRT, RPSGT (CO-OWNER)
- **Authorized official phone:** (270) 575-0080

## Contact information

- **Practice address:** 3125 PARISA DRIVE, PADUCAH, KY 42003
- **Practice address phone:** (270) 575-0080
- **Practice address fax:** (270) 575-0081
- **Mailing address:** 105 NOLAN AVE, FULTON, KY 42041-8220
- **Mailing address phone:** (270) 575-0080
- **Mailing address fax:** (270) 575-0081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/04/2008
- **Last updated:** 05/19/2009