Individual
CLIFFORD LEE HAZELWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4470 BARDSTOWN RD, HODGENVILLE, KY 42748-9313
(270) 763-3313
Mailing address
4470 BARDSTOWN RD, HODGENVILLE, KY 42748-9313
(270) 786-3313
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1092982
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3017161
KY
Other
Enumeration date
08/21/2021
Last updated
01/06/2023
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