National Provider Identifier Database

VANDERBILT INTEGRATED PROVIDERS
Pediatrics


Contact Information

VANDERBILT INTEGRATED PROVIDERS
1717 HIGH STREET
SUITE 3A
HOPKINSVILLE, KY42240
Phone: 270-885-8445
Fax: 270-886-9106
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X

* Indicates primary specialty

NPI Profile & details for VANDERBILT INTEGRATED PROVIDERS

NPI Number 1255463949
Legal business name
LBN
VANDERBILT INTEGRATED PROVIDERS
Authorized official CHRIS WESTBROOK - (ASSISTANT DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 03/09/2007
Last updated 02/27/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • KY License #: 3002428
  • KY License #: 3004549
  • KY Medicaid: 78900800

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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