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Organization
HEART SPECIALISTS OF SE KY PSC
Active
Organization
HEART SPECIALISTS OF SE KY PSC
Active
Other names
HEART SPECIALISTS OF SE KY PSC
Organization subpart
No
Provider details
NPI number
Authorized official
JANIE RENEE OKUMA (OFFICE MANAGER)
(606) 523-9010
Entity
Organization
Contact information
Practice address
45 MOONBOW PLZ, CORBIN, KY 40701-8949
(606) 523-9010
(606) 523-5923
Mailing address
45 MOONBOW PLZ, CORBIN, KY 40701-8949
(606) 523-9010
(606) 523-5923
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29557
KY
363A00000X
Physician Assistant
PA249
KY
363L00000X
Nurse Practitioner
4069P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65914996
—
KY
Enumeration date
08/27/2006
Last updated
06/30/2008
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