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PURCHASE DERM-ENT PLLC NPI 1336101179


NPI Information

NPI: 1336101179
Provider Name: PURCHASE DERM-ENT, PLLC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization
Address:
2605 KENTUCKY AVENUE
DOB 3, SUITE 601
PADUCAH, KY
ZIP 42003
Phone: (270) 408-4368
Get Directions

PURCHASE DERM-ENT, PLLC is an otolaryngology in Paducah, KY. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. PURCHASE DERM-ENT, PLLC NPI is 1336101179. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2605 KENTUCKY AVENUE
DOB 3, SUITE 601
PADUCAH, KY
ZIP 42003-800
Phone: (270) 408-4368
Fax: (570) 408-3272

The provider's authorized official is Shawn C Jones .
The authorized official title is Partner and has the following contact phone number (570) 408-4368.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 5/30/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyNo
2231H00000XAudiologistNo
3207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100198720MEDICAIDKENTUCKY
25897MEDICARE PIN
378903721MEDICAIDKENTUCKY
45897MEDICARE PINKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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