Lourdes Medical Pavilion, LLC

Organization Active NPI Family Medicine Physician · Kuttawa, KY

NPI 1528058377 · NPPES record last updated Mar 16, 2010

Key facts

NPI
1528058377
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
28168 (KY)
Legal business name
LOURDES MEDICAL PAVILION, LLC
Practice address
97 Lakeshore Dr
Kuttawa, KY 42055-6202
Phone
(270) 388-4357
NPI assigned
Oct 24, 2005
Organization subpart
No

Authorized official

Name
Mr. Mark Thompson
Title
Cfo
Phone
(270) 444-2117

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lourdes Medical Pavilion LLC (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 28168 KY Yes

Addresses

Primary practice location

97 Lakeshore Dr
Kuttawa, KY 42055-6202

Mailing address

PO Box 8329
Paducah, KY 42002-8329
Phone (270) 441-4125

Other names

  • LYON COUNTY FAMILY CARE Doing business as

Other providers in Kuttawa, KY

All providers in Kuttawa, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.