NPIMap

Organization Active NPI

East Kentucky Eye Ear Nose and Thorat Specialists LLC

  • Otolaryngology Physician
  • Pikeville, KY
National Provider Identifier
1295746360
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
02303 Issued in KY
Legal business name
EAST KENTUCKY EYE EAR NOSE AND THORAT SPECIALISTS LLC
Practice address
255 Church St
Suite 101
Pikeville, KY 41501-3476
Phone
(606) 432-4494
Fax
(606) 432-0430
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gregory V Hazelett, D.O.
Title
Managing Partner
Phone
(606) 432-4494

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 22584 KY
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X 02303 KY Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA295 KY

Addresses

Primary practice location

255 Church St
Suite 101
Pikeville, KY 41501-3476

Mailing address

255 Church St
Suite 101
Pikeville, KY 41501-3476
Phone (606) 432-4494

Other identifiers 1

IdentifierTypeStateIssuer
65935405MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1295746360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CHURCH ST",
            "address_2": "SUITE 101",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013476",
            "telephone_number": "606-432-4494",
            "fax_number": "606-432-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CHURCH ST",
            "address_2": "SUITE 101",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013476",
            "telephone_number": "606-432-4494",
            "fax_number": "606-432-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST KENTUCKY EYE EAR NOSE AND THORAT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "HAZELETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "606-432-4494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "22584",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "02303",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65935405",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.