Organization
CARDIOVASCULAR CONSULTANTS OF KENTUCKY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW K SHOTWELL M.D. (OWNER/PHYSICIAN)
(859) 744-0263
Entity
Organization
Contact information
Practice address
191 WAL MART WAY, MAYSVILLE, KY 41056-7518
(859) 744-0263
(859) 745-0836
Mailing address
191 WAL MART WAY, MAYSVILLE, KY 41056-7518
(859) 744-0263
(859) 745-0836
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35596
KY
363A00000X
Physician Assistant
PA562
KY
363LF0000X
Family Nurse Practitioner
3007563
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078741
—
OH
05
—
7100240350
—
KY
Enumeration date
11/16/2012
Last updated
10/16/2015
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