Provider Demographics
NPI:1043561640
Name:ALLERGY AND ASTHMA SPECIALISTS, PSC
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA SPECIALISTS, PSC
Other - Org Name:NURSE PRACTITIONER GROUP OF ALLERGY AND ASTHMA SPECIALISTS, PSC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:STANTON
Authorized Official - Last Name:CLORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:270-684-6144
Mailing Address - Street 1:3604 WATHENS XING
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-7035
Mailing Address - Country:US
Mailing Address - Phone:270-684-6144
Mailing Address - Fax:270-684-2944
Practice Address - Street 1:3604 WATHENS XING
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-7035
Practice Address - Country:US
Practice Address - Phone:270-684-6144
Practice Address - Fax:270-684-2944
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLERGY AND ASTHMA SPECIALISTS, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-24
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty