Organization
KNOX FAMILY MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL C PEDERSEN MD (PRESIDENT)
(606) 546-6027
Entity
Organization
Contact information
Practice address
602 KNOX ST, BARBOURVILLE, KY 40906-1304
(606) 546-6027
(606) 546-2084
Mailing address
602 KNOX ST, BARBOURVILLE, KY 40906-1304
(606) 546-6027
(606) 546-2084
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001064
—
KY
Enumeration date
11/09/2006
Last updated
09/14/2011
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