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Organization
JENNIE STUART MEDICAL CENTER
Active
Organization
JENNIE STUART MEDICAL CENTER
Active
Other names
Wound Healing Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA RUSSELL (DIRECTOR PATIENT FINANCIAL SERVICES)
(270) 887-0100
Entity
Organization
Contact information
Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42241-2400
(270) 887-0100
(270) 887-0425
Mailing address
PO BOX 2400, HOPKINSVILLE, KY 42241-2400
(270) 887-0100
(270) 887-0425
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000212362
BLUE CROSS
KY
05
—
7890378800
—
KY
Enumeration date
01/02/2007
Last updated
08/22/2020
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