Organization
SHELDON D. SIMON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARRIE J JONES (OFFICE MANAGER)
(270) 683-4844
Entity
Organization
Contact information
Practice address
1700 FREDERICA ST STE 103, OWENSBORO, KY 42301-4833
(270) 683-4844
(270) 926-8366
Mailing address
1700 FREDERICA ST STE 103, OWENSBORO, KY 42301-4833
(270) 683-4844
(270) 926-8366
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45803004
—
KY
Enumeration date
12/05/2007
Last updated
12/05/2007
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