Organization
COMMUNITY MEDICAL ASSOCIATES - BOWLING GREEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (VP - MANAGED CARE)
(502) 272-5332
Entity
Organization
Contact information
Practice address
615 7TH AVE, BOWLING GREEN, KY 42101-6921
(270) 846-4800
(270) 846-4828
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
04/30/2024
Last updated
03/06/2025
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