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Individual

SHANE ERIC HENDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1532 LONE OAK RD, SUITE 310, PADUCAH, KY 42003-7913
(270) 443-0777
(270) 443-0999
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(513) 981-5130
(513) 981-5015

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO927
AL
207RG0100X
Gastroenterology Physician
Primary
03280
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100129950
KY
Enumeration date
05/17/2006
Last updated
04/21/2015
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