Organization
PURCHASE DERM-ENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN C JONES M.D. (PARTNER)
(570) 408-4368
Entity
Organization
Contact information
Practice address
2605 KENTUCKY AVENUE, DOB 3, SUITE 601, PADUCAH, KY 42003-3800
(270) 408-4368
(570) 408-3272
Mailing address
2605 KENTUCKY AVENUE, DOB 3, SUITE 601, PADUCAH, KY 42003-3800
(270) 408-4368
(570) 408-3272
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
231H00000X
Audiologist
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100198720
—
KY
05
—
78903721
—
KY
Enumeration date
04/05/2006
Last updated
05/30/2012
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