Organization
ANESTHESIOLOGY OF PADUCAH, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA L FREEMAN (OFFICE MANAGER)
(270) 442-8228
Entity
Organization
Contact information
Practice address
2501 KENTUCKY AVENUE, WESTERN BAPTIST HOSPITAL, PADUCAH, KY 42003
(270) 575-2100
Mailing address
2507 BROADWAY, PADUCAH, KY 42001-3124
(270) 442-8228
(270) 442-9566
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65923849
—
KY
Enumeration date
12/12/2006
Last updated
06/15/2011
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