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Organization

ENTLC, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL A CONRAD M.D., F.A.C.S. (PRESIDENT)
(606) 759-4852
Entity
Organization

Contact information

Practice address
491 TUCKER DR, MAYSVILLE, KY 41056-9111
(606) 759-4852
(606) 759-0112
Mailing address
491 TUCKER DRIVE, MAYSVILLE, KY 41056-9111
(606) 759-4852
(606) 759-0112

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35183
KY
231H00000X
Audiologist
0478
KY
237700000X
Hearing Instrument Specialist
0946
KY
363LF0000X
Family Nurse Practitioner
6223P
KY

Other

Enumeration date
10/19/2007
Last updated
06/13/2013
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