Individual
DR. JOSHUA A PEDIGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 745-1000
Mailing address
250 PARK ST, BOWLING GREEN, KY 42101-1760
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101254751
VA
207P00000X
Emergency Medicine Physician
Primary
46880
KY
207R00000X
Internal Medicine Physician
46880
KY
208M00000X
Hospitalist Physician
46880
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000876833
ANTHEM
KY
05
—
7100261680
—
KY
Enumeration date
05/17/2011
Last updated
02/15/2021
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