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Organization
BOURBON PHYSICIAN PRACTICE LLC
Active
Organization
BOURBON PHYSICIAN PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
9 LINVILLE DR, PARIS, KY 40361-2129
(859) 987-3600
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
231H00000X
Audiologist
—
NULL
231H00000X
Audiologist
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
04/29/2014
Last updated
09/24/2022
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