Organization
NEUROLOGY GROUP OF PADUCAH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAN M WOELTZ (OWNER)
(270) 443-2830
Entity
Organization
Contact information
Practice address
2603 KENTUCKY AVE, SUITE 402, PADUCAH, KY 42003-3814
(270) 443-2830
(270) 443-7108
Mailing address
2603 KENTUCKY AVE, SUITE 402, PADUCAH, KY 42003-3814
(270) 443-2830
(270) 443-7108
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
87743
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1391
NEUROLOGY GROUP PTAN
IL
05
—
65939647
—
KY
Enumeration date
08/28/2006
Last updated
03/24/2011
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