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Organization
BOURBON COMMUNITY HOSPITAL
Active
Organization
BOURBON COMMUNITY HOSPITAL
Active
Other names
BOURBON COMMUNITY HOSP ER PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
DANA L EVANS (PROVIDER ENROLLMENT REP)
(270) 744-9600
Entity
Organization
Contact information
Practice address
9 LINVILLE DR, PARIS, KY 40361-2129
(859) 987-1018
(859) 987-1144
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000063648
BCBS GROUP
KY
05
—
65939324
—
KY
Enumeration date
03/22/2007
Last updated
09/11/2025
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