Organization
SOMERSET PEDIATRIC SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANIE ISON (ASST. OFFICE MANAGER)
(606) 678-8155
Entity
Organization
Contact information
Practice address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
Mailing address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100087290 - MD
—
KY
05
—
7100087330 - NP
—
KY
Enumeration date
05/26/2009
Last updated
12/04/2012
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