Individual
EVELYN SALISBURY MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
117 WEST SOUTH ST, MUNFORDVILLE, KY 42765
(270) 524-7231
(270) 524-7415
Mailing address
PO BOX 579, MUNFORDVILLE, KY 42765
(270) 524-7231
(270) 524-7415
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19100
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000046107
ANTHUB BCBS
KY
01
—
1064170
PASSPORT MEDICAID MGDCARE
KY
05
—
64191000
—
KY
Enumeration date
04/20/2006
Last updated
02/20/2017
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