Organization
SHELBY PEDIATRICS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC J SIEGEL MD (MEDICAL DOCTOR)
(502) 633-7337
Entity
Organization
Contact information
Practice address
71 MACK WALTERS RD, SHELBYVILLE, KY 40065-1751
(502) 633-7337
(502) 633-7338
Mailing address
71 MACK WALTERS RD, SHELBYVILLE, KY 40065-1751
(502) 633-7337
(502) 633-7338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1121406
KY
208000000X
Pediatrics Physician
Primary
28387
KY
363AM0700X
Medical Physician Assistant
PA557
KY
363LP0200X
Pediatric Nurse Practitioner
3006166
KY
363LP0200X
Pediatric Nurse Practitioner
3007777
KY
Other
Enumeration date
01/23/2007
Last updated
03/27/2013
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