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Individual

DR. CHARLES KENNY MAFFET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
105 DIECKS DR, ELIZABETHTOWN, KY 42701-2444
(270) 737-6300
Mailing address
1117 CAVE RUN LN, ELIZABETHTOWN, KY 42701-5541
(270) 872-7105

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
15586
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4444056018002
KY
Enumeration date
05/24/2007
Last updated
12/08/2010
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