Organization
PURCHASE NEUROLOGY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN EDWARD GRUBBS MD (PRESIDENT)
(270) 441-4400
Entity
Organization
Contact information
Practice address
225 MEDICAL CENTER DRIVE, SUITE 402, PADUCAH, KY 42003
(270) 441-4400
(270) 441-4409
Mailing address
225 MEDICAL CENTER DR, SUITE 402, PADUCAH, KY 42003-7914
(270) 441-4400
(270) 441-4409
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65917908
—
KY
01
—
C13976
RAILROAD MEDICARE
KY
Enumeration date
10/14/2006
Last updated
10/25/2007
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