| Medical Specialists Of Central Kentucky, P.s.c. | |
|
350 Park St Suite 206 Bowling Green KY 42101-1784 | |
| (270) 746-0440 | |
| (270) 746-0882 |
| Full Name | Medical Specialists Of Central Kentucky, P.s.c. |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 350 Park St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Rebecca Dawn Shadowen (OWNER, PRESIDENT) |
| Authorized Official Contact | 2707460440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Specialists Of Central Kentucky, P.s.c. Po Box 51726 Bowling Green KY 42102-6726 Ph: (270) 746-0440 | Medical Specialists Of Central Kentucky, P.s.c. 350 Park St Suite 206 Bowling Green KY 42101-1784 Ph: (270) 746-0440 |
| NPI Number | 1134320492 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 02/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134320492 | NPI | - | NPPES |
| 000000051271 | Other | KY | BLUE CROSS BLUE SHIELD |
| 65935504 | Medicaid | KY | |
| 10806088 | Other | KY | CAQH |
| CC3484 | Other | KY | RR MEDICARE |
| 1255438420 | Other | KY | NPI FOR DR. R. SHADOWEN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 26582 (Kentucky) | Primary |
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