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Individual

DR. KAREN CUMMINGS BANISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2850 LONE OAK RD, BAYLEY SQUARE, SUITE 4, PADUCAH, KY 42003-8043
(270) 554-3904
(270) 534-8928
Mailing address
2850 LONE OAK RD, BAYLEY SQUARE, SUITE 4, PADUCAH, KY 42003-8043
(270) 554-3904
(270) 534-8928

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32562
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64325624
KY
Enumeration date
12/07/2006
Last updated
07/09/2010
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