Organization
PARK STREET PARTNERS, L.L.P.
Active
Other names
URGENTCARE
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD G. SOWELL (EXECUTIVE VICE PRESIDENT)
(270) 745-1536
Entity
Organization
Contact information
Practice address
1225 FAIRWAY ST, BOWLING GREEN, KY 42103-2477
(270) 781-3910
(270) 842-7177
Mailing address
PO BOX 3240, BOWLING GREEN, KY 42102-3240
(270) 745-1100
(270) 745-1156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65900813
—
KY
05
—
78900982
—
KY
Enumeration date
07/03/2006
Last updated
09/02/2011
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