Organization
EAST KENTUCKY EYE EAR NOSE AND THORAT SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY V HAZELETT D.O. (MANAGING PARTNER)
(606) 432-4494
Entity
Organization
Contact information
Practice address
255 CHURCH ST, SUITE 101, PIKEVILLE, KY 41501-3476
(606) 432-4494
(606) 432-0430
Mailing address
255 CHURCH ST, SUITE 101, PIKEVILLE, KY 41501-3476
(606) 432-4494
(606) 432-0430
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
22584
KY
207Y00000X
Otolaryngology Physician
Primary
02303
KY
363A00000X
Physician Assistant
PA295
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65935405
—
KY
Enumeration date
08/11/2006
Last updated
12/09/2013
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