Organization
PAMELA K HARSTON, MD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA KAYE HARSTON MD (BUSINESS OWNER)
(270) 904-6160
Entity
Organization
Contact information
Practice address
1890 LYDA AVE, SUITE 103, BOWLING GREEN, KY 42104-5829
(270) 904-6160
(270) 904-6165
Mailing address
1890 LYDA AVE, SUITE 103, BOWLING GREEN, KY 42104-5829
(270) 904-6160
(270) 904-6165
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
KY25936
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64259369
—
KY
Enumeration date
10/13/2009
Last updated
11/12/2010
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