Organization
W. EDWARD SHUTTLEWORTH PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM EDWARD SHUTTLEWORTH MD (OWNER)
(270) 338-9653
Entity
Organization
Contact information
Practice address
1008 MEDICAL CENTER DR STE A, POWDERLY, KY 42367-5463
(270) 338-9653
(270) 338-9656
Mailing address
1008 MEDICAL CENTER DR STE A, POWDERLY, KY 42367-5463
(270) 338-9653
(270) 338-9656
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64178551
—
KY
Enumeration date
03/23/2010
Last updated
03/23/2010
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