Organization
SOUTHERN ENT ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE SAMMONS (OFFICE MANAGER)
(606) 788-9304
Entity
Organization
Contact information
Practice address
404 EUCLID AVE, PAINTSVILLE, KY 41240-1167
(606) 788-9304
Mailing address
404 EUCLID AVE, PAINTSVILLE, KY 41240-1167
(606) 788-9304
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65903486
—
KY
Enumeration date
03/02/2010
Last updated
03/02/2010
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