Organization
PEDIATRIC PARTNERS OF WESTERN KY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T HOUSTON MD (OWNER)
(270) 926-8828
Entity
Organization
Contact information
Practice address
1102 TRIPLETT ST, STE 1000, OWENSBORO, KY 42303-3104
(270) 926-8828
(270) 926-0760
Mailing address
1102 TRIPLETT ST, STE 1000, OWENSBORO, KY 42303-3104
(270) 926-8828
(270) 926-0760
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
21411
KY
173000000X
Legal Medicine
40582
KY
173000000X
Legal Medicine
42304
KY
363AM0700X
Medical Physician Assistant
PA787
KY
363L00000X
Nurse Practitioner
3007096
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64127582
—
KY
05
—
64214117
—
KY
Enumeration date
09/26/2008
Last updated
05/24/2012
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