Organization
COMPREHENSIVE NEUROLOGICAL SERVICES
Active
Other names
Salem Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM HOGANCAMP M.D. (ATTENDING PHYSICIAN)
(270) 575-9990
Entity
Organization
Contact information
Practice address
131 HOSPITAL DR, SALEM, KY 42078-8043
(270) 575-9990
(270) 575-9950
Mailing address
3121 PARISA DR, PADUCAH, KY 42003-4584
(270) 575-9990
(270) 575-9950
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
32561
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323921
ANTHEM BC/BS
KY
01
—
05156
RR MEDICARE GROUP #
KY
01
—
0906001
MEDICARE
KY
05
—
64325616
—
KY
01
—
65940652
MEDICAID GROUP #
KY
01
—
9060
MEDICARE GROUP #
KY
01
—
P00110715
RR MEDICARE #
KY
Enumeration date
09/25/2007
Last updated
10/24/2007
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