Individual
DR. IVAN ALEXANDER ESCUDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
912 WALLACE AVE STE 102, LEITCHFIELD, KY 42754-2405
(270) 259-8888
(270) 259-8887
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57355
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2020
Last updated
04/30/2024
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