Individual
RUSSELL E PEYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 824-6655
(270) 824-6629
Mailing address
2700 STANLEY GAULT PKWY, SUITE 129, LOUISVILLE, KY 40223-5132
(866) 273-5392
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006839
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000733164
BCBS
KY
05
—
7100156510
—
KY
Enumeration date
02/22/2011
Last updated
03/15/2017
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