# DIANA M. STULC, PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306813431
- **Authorized official:** DR. DIANA MINASSIAN STULC M.D. (OWNER)
- **Authorized official phone:** (270) 825-4204

## Contact information

- **Practice address:** 444 S MAIN ST, MADISONVILLE, KY 42431-2871
- **Practice address phone:** (270) 825-4204
- **Practice address fax:** (270) 825-4274
- **Mailing address:** 444 S MAIN ST, MADISONVILLE, KY 42431-2871
- **Mailing address phone:** (270) 825-4204
- **Mailing address fax:** (270) 825-4274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | N/A | KY | Yes |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | NO GROUP \# | — | KY |