Individual
JESSICA L RAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2801 NEW HARTFORD RD, OWENSBORO, KY 42303
(270) 926-1336
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
51118
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2012
Last updated
06/15/2022
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