Organization
OWENSBORO HEALTH MEDICAL GROUP INC
Active
Parent organization
OWENSBORO HEALTH INC
Other names
Owensboro Health Medical Group - Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
OWENSBORO HEALTH INC
Authorized official
JOHN T HACKBARTH JR. (SECRETARY)
(270) 417-4813
Entity
Organization
Contact information
Practice address
2816 VEACH RD, SUITE 403, OWENSBORO, KY 42303
(270) 684-1145
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 691-8070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201200950
—
IN
05
—
7100364320-MD
—
KY
05
—
7100382410-NP
—
KY
Enumeration date
05/26/2015
Last updated
08/22/2018
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