Organization
WILLIAM G DEVINE M.D. PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G DEVINE M.D. (EXECUTIVE DIRECTOR)
(270) 827-0353
Entity
Organization
Contact information
Practice address
1305 N ELM ST, HENDERSON, KY 42420-2783
(270) 827-7700
(270) 827-4966
Mailing address
PO BOX 1079, HENDERSON, KY 42419-1079
(270) 827-0353
(270) 827-4966
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
35368
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325047
ANTHEM BC & BS
KY
05
—
64003551
—
KY
Enumeration date
02/17/2006
Last updated
04/20/2008
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