Organization
MEDICAL SPECIALISTS OF CENTRAL KENTUCKY, P.S.C.
Active
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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