Organization
MEDICAL SPECIALISTS OF CENTRAL KENTUCKY, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA DAWN SHADOWEN M.D. (OWNER, PRESIDENT)
(270) 746-0440
Entity
Organization
Contact information
Practice address
350 PARK ST, SUITE 206, BOWLING GREEN, KY 42101-1784
(270) 746-0440
(270) 746-0882
Mailing address
PO BOX 51726, BOWLING GREEN, KY 42102-6726
(270) 746-0440
(270) 746-0882
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
26582
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051271
BLUE CROSS BLUE SHIELD
KY
01
—
10806088
CAQH
KY
01
—
1255438420
NPI FOR DR. R. SHADOWEN
KY
05
—
65935504
—
KY
01
—
CC3484
RR MEDICARE
KY
Enumeration date
05/31/2007
Last updated
02/01/2008
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