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Organization

JENNIE STUART MEDICAL CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ERIC ALAN LEE (PRESIDENT / CEO)
(270) 887-0100
Entity
Organization

Contact information

Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
(270) 887-9266
Mailing address
PO BOX 2400, 320 W 18TH ST, HOPKINSVILLE, KY 42241-2400
(270) 887-0100
(270) 887-9266

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
207L00000X
Anesthesiology Physician
207Q00000X
Family Medicine Physician
6593432500
KY
207RC0000X
Cardiovascular Disease Physician
65939332
KY
2084N0400X
Neurology Physician
208600000X
Surgery Physician
65941742
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
78903788
KY
208M00000X
Hospitalist Physician
7100104890
KY
282N00000X
General Acute Care Hospital
Primary
100068
KY
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LN0000X
Neonatal Nurse Practitioner
364SF0001X
Family Health Clinical Nurse Specialist
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000054549
BLUE CROSS PROVIDER
KY
01
000000212362
BLUE CROSS PHYSICIAN
KY
05
01010859
KY
01
039724400
KENTUCKY BLACK LUNG
KY
05
1066495
KY
01
163067200
US DEPT OF LABOR
KY
05
6593432500
KY
05
65939332
KY
05
65941742
KY
05
7100104890
KY
05
78903788
KY
Enumeration date
07/29/2005
Last updated
04/09/2025
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