| Ciampa Oral Surgery, P.s.c. | |
|
200 Medical Center Dr Paducah KY 42003-7911 | |
| (270) 442-4374 | |
| (270) 442-1878 |
| Full Name | Ciampa Oral Surgery, P.s.c. |
|---|---|
| Speciality | Dentist |
| Location | 200 Medical Center Dr, Paducah, Kentucky |
| Authorized Official Name and Position | Peter R. Ciampa (PRESIDENT) |
| Authorized Official Contact | 2704424374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ciampa Oral Surgery, P.s.c. 200 Medical Center Dr Paducah KY 42003-7911 Ph: (270) 442-4374 | Ciampa Oral Surgery, P.s.c. 200 Medical Center Dr Paducah KY 42003-7911 Ph: (270) 442-4374 |
| NPI Number | 1265561872 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 08/16/2010 |
| Medicare PECOS PAC ID | 0345212973 |
|---|---|
| Medicare Enrollment ID | O20040812000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265561872 | NPI | - | NPPES |
| 65934044 | Medicaid | KY | |
| 542505 | Other | KY | UNITED CONCORDIA INS |
| 61900361 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5552 (Kentucky) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5552 (Kentucky) | Primary |
| Provider Name | Peter R Ciampa |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346379948 PECOS PAC ID: 2668756529 Enrollment ID: I20170221002895 |
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