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Contact Information

MAYSVILLE INTERNAL MEDICINE PEDIATRIC ASSOC PSC
2009 OLD MAIN ST
MAYSVILLE, KY41056
 Phone: 606-759-7615
 Fax: 606-759-7821
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MAYSVILLE INTERNAL MEDICINE PEDIATRIC ASSOC PSC · (Female)

NPI # 1841373412
Status Active
Credentials
Entity Individual
Enumeration date 10/24/2006
Last updated 06/09/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 24430
  • KY Medicaid 65933012
  • KY Medicaid 7100379280
  • Other C78288 DR WALLINGFORDS UPIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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