STEPHANIE N. SOUTHARD PSC NPI 1629267315

NPI Information

NPI: 1629267315
Provider Name: STEPHANIE N. SOUTHARD, PSC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1215 N MAIN ST
SUITE 2
MONTICELLO, KY
ZIP 42633
Phone: (606) 340-8825
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STEPHANIE N. SOUTHARD, PSC is a primary care clinic center in Monticello, KY. STEPHANIE N. SOUTHARD, PSC NPI is 1629267315. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1215 N MAIN ST
SUITE 2
MONTICELLO, KY
ZIP 42633-900
Phone: (606) 340-8825
Fax: (606) 340-0097

The provider's authorized official is Stephanie Nicole Southard .
The authorized official title is President and has the following contact phone number (606) 340-8825.

The enumeration date for this NPI number is 10/18/2007 and was last updated on 6/3/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	261QP2300X	Clinic/Center	Primary Care	02809	KENTUCKY	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00461001	MEDICARE PIN	KENTUCKY
2	64061807	MEDICAID	KENTUCKY

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: 5/5/2024

NPI Synchronization or Removal

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