Individual
IRVIN SOUTHWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSS
Contact information
Practice address
80 HIGHWAY 2227, SOMERSET, KY 42503-1562
(606) 485-4003
Mailing address
80 HIGHWAY 2227, SOMERSET, KY 42503-1562
(606) 485-4003
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1206172
KY
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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