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Organization
KINGS DAUGHTERS MEDICAL SPECIALTIES INC
Active
Organization
KINGS DAUGHTERS MEDICAL SPECIALTIES INC
Active
Other names
Kings Daughters Medical Specialties Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE M WHITLATCH (CEO/PRESIDENT)
(606) 408-4401
Entity
Organization
Contact information
Practice address
1200 CENTRAL AVE STE 3, ASHLAND, KY 41101-7575
(606) 325-1894
(606) 325-9193
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3036673
—
KY
05
—
3810016581
—
WV
05
—
7100112610
—
KY
Enumeration date
03/03/2010
Last updated
02/16/2016
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