Organization
MATTHEW C BIRDWHISTELL DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW C BIRDWHISTELL D.O. (OWNER)
(502) 863-0721
Entity
Organization
Contact information
Practice address
1138 LEXINGTON RD, SUITE 290, GEORGETOWN, KY 40324-9672
(502) 863-0721
(502) 863-6104
Mailing address
1138 LEXINGTON RD, SUITE 290, GEORGETOWN, KY 40324-9672
(502) 863-0721
(502) 863-6104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
03293
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100160510
—
KY
Enumeration date
01/29/2013
Last updated
01/29/2013
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