Organization
ERTEL MEDICINE & PEDIATRICS-POWELL, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ERTEL MD (OWNER)
(606) 663-2511
Entity
Organization
Contact information
Practice address
68 E ELKINS ST, STANTON, KY 40380-2311
(606) 663-2511
(606) 663-0711
Mailing address
PO BOX 296, STANTON, KY 40380-0296
(606) 663-2511
(606) 663-0711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35650
KY
208000000X
Pediatrics Physician
35650
KY
261QR1300X
Rural Health Clinic/Center
Primary
35650
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100003440
—
KY
Enumeration date
01/05/2007
Last updated
08/20/2014
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