Individual
EUGENE HERMAN SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1698 OLD LEBANON RD, SUITE 2A, CAMPBELLSVILLE, KY 42718-9662
(270) 465-2821
(270) 789-1756
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 465-2821
(270) 789-1756
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15931
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64159312
—
KY
Enumeration date
12/14/2005
Last updated
09/20/2007
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