Individual
MRS. ANITA J FLEENOR-FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1903 BROADWAY, PADUCAH, KY 42001-7105
(270) 444-9889
(270) 444-9291
Mailing address
1903 BROADWAY, PADUCAH, KY 42001-7105
(270) 444-9889
(270) 444-9291
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
34325
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000282527
ANTHEM BCBS
KY
05
—
0360929991
—
IL
01
—
34325
KY STATE LIC.
KY
05
—
64343254
—
KY
Enumeration date
06/10/2005
Last updated
08/09/2019
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