Individual
PAUL CHRISTEN PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 KNOX ST, BARBOURVILLE, KY 40906-1304
(606) 546-6027
(606) 546-2084
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
31705
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64317050
—
KY
01
—
P01427263
RR MEDICARE
KY
Enumeration date
12/15/2005
Last updated
12/07/2020
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