Individual
CHOCTAW BRODIE BADGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8340 U.S. 60 WEST, LEWISPORT, KY 42351
(270) 926-1229
(270) 295-3716
Mailing address
PO BOX 241, LEWISPORT, KY 42351-0241
(270) 295-3711
(270) 295-3716
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
KY. 4697
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60046976
—
KY
Enumeration date
04/17/2007
Last updated
07/09/2007
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