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Contact Information

UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC
811 E PARRISH AVE
STE 120
OWENSBORO, KY42303-3258
 Phone: 502-852-7670
 Fax: 502-852-7743
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for UNIVERSITY PEDIATRIC GASTROENTEROLOGY LLC · (Female)

NPI Number 1811296742
Status Active
Credentials
Entity Individual
Enumeration date 03/17/2011
Last updated 03/17/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 200945670
  • KY Medicaid 7100063520
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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