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Individual
PAUL LARRY DASSOW
Active
Individual
PAUL LARRY DASSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34878
KY
207QA0000X
Adolescent Medicine (Family Medicine) Physician
34878
KY
207QA0505X
Adult Medicine Physician
34878
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
34878
KY
Other
Enumeration date
06/15/2006
Last updated
06/27/2012
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