Ladies Clinic , PSC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

23151 Issued in KY

Legal business name

LADIES CLINIC , PSC

Practice address

347 Bogle St Ste a
Somerset, KY 42503-2873

Phone

(606) 679-7353

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dennis R Faulkner, MD

Title

President

Phone

(606) 679-7353

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1902928898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 BOGLE ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032873",
            "telephone_number": "606-679-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 BOGLE ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032873",
            "telephone_number": "606-679-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADIES CLINIC , PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-679-7353",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "23151",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "1358P",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "5888P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64231517",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7423",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.