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Organization

HEARTLAND PATHOLOGY CONSULTANTS, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GWENDOLYN GODFREY DO (PRESIDENT)
(270) 706-1212
Entity
Organization

Contact information

Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 706-1212
Mailing address
PO BOX 561, ELIZABETHTOWN, KY 42702-0561
(270) 360-0199

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65931511
KY
01
CI3480
MEDICARE RAILROAD
Enumeration date
09/20/2006
Last updated
03/28/2024
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