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Individual

HAZEL L JOSEPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD, PHD

Contact information

Practice address
611 W POPLAR ST, ELIZABETHTOWN, KY 42701-2431
(270) 704-3599
Mailing address
PO BOX 757, ELIZABETHTOWN, KY 42702-0757
(270) 704-3599
(270) 731-0261

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
38878
KY
208600000X
Surgery Physician
38878
KY
208D00000X
General Practice Physician
Primary
38878
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00731001
MEDICARE INDIVIDUAL NUMBER
KY
Enumeration date
05/04/2006
Last updated
04/15/2023
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