Organization
JENNIE STUART MEDICAL CENTER
Active
Other names
Wound Healing Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA RUSSELL (DIRECTOR PATIENT FINANCIAL SERVICES)
(270) 887-0646
Entity
Organization
Contact information
Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
(270) 887-0425
Mailing address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
(270) 887-0425
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000212362
BC PROVIDER NUMBER
KY
05
—
6594174200
—
KY
Enumeration date
01/17/2007
Last updated
08/22/2020
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