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Individual

JOHN L. PELLEGRINI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
214 HOSPITAL RD, SUITE 1, WHITESBURG, KY 41858-7627
(606) 633-2255
(606) 633-3814
Mailing address
255 MAIN ST, P.O. BOX 983, WHITESBURG, KY 41858-7315
(606) 633-2261
(606) 633-9643

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101035778
VA
208600000X
Surgery Physician
Primary
19935
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007358229
VA
05
64199359
KY
Enumeration date
09/15/2005
Last updated
12/10/2009
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