Individual
DR. JOEL O LILLEVIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003
(270) 575-2100
Mailing address
2507 BROADWAY, PADUCAH, KY 42001
(270) 442-8228
(270) 442-9566
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
24592
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64245921
—
KY
Enumeration date
09/27/2006
Last updated
07/08/2007
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