Individual
DR. JAMES RANDALL HANSBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0473
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0473
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
29620
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044750
ANTHEM
KY
01
—
1107702
PASSPORT
KY
01
—
290005698
RAILROAD MEDICARE
KY
05
—
64296205
—
KY
Enumeration date
06/09/2005
Last updated
10/17/2016
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