Individual
DR. SHANNON K BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
413 SOUTH LOOP ROAD, ST ELIZABETH FAMILY PRACTICE CENTER, EDGEWOOD, KY 41017-5446
(859) 301-3800
(859) 301-3987
Mailing address
413 S LOOP RD, ST ELIZABETH FAMILY PRACTICE CENTER, EDGEWOOD, KY 41017-5446
(859) 301-3800
(859) 301-3987
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22184
WV
207Q00000X
Family Medicine Physician
35.075269
OH
207Q00000X
Family Medicine Physician
Primary
49699
KY
207VX0000X
Obstetrics Physician
49699
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100457110
—
KY
01
—
K228150
KY MEDICARE
KY
Enumeration date
03/24/2006
Last updated
08/10/2022
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