Organization
JOHN D MICHELMAN, MD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA DERR (PROVIDER ENROLLMENT SPECIALIST)
(270) 744-9600
Entity
Organization
Contact information
Practice address
861 CORPORATE DR, SUITE 103, LEXINGTON, KY 40503-5432
(859) 224-2022
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
37523
KY
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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