Caldwell County Medical Clinic

Organization Active NPI Nephrology Physician · Princeton, KY

NPI 1801905906 · NPPES record last updated Mar 17, 2009

Key facts

NPI
1801905906
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
Legal business name
CALDWELL COUNTY MEDICAL CLINIC
Practice address
323 S Jefferson St
Suite D
Princeton, KY 42445-2100
Phone
(270) 365-4505
Fax
(270) 365-4539
NPI assigned
Aug 30, 2006
Organization subpart
No

Authorized official

Name
Dana Evans
Title
Provider Enrollment Rep
Phone
(270) 744-9600

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RN0300X Yes

Addresses

Primary practice location

323 S Jefferson St
Suite D
Princeton, KY 42445-2100

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

Other identifiers

IdentifierTypeStateIssuer
65942872MedicaidKY

Other providers in Princeton, KY

All providers in Princeton, KY · Nephrology Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.