Provider Demographics
NPI:1235366238
Name:OWENSBORO MEDICAL PRACTICE, PLLC
Entity Type:Organization
Organization Name:OWENSBORO MEDICAL PRACTICE, PLLC
Other - Org Name:THE HANCOCK CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:F MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-691-1830
Mailing Address - Street 1:1200 BRECKENRIDGE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1089
Mailing Address - Country:US
Mailing Address - Phone:270-683-8672
Mailing Address - Fax:270-691-1870
Practice Address - Street 1:185 STATE ROUTE 271 S
Practice Address - Street 2:
Practice Address - City:LEWISPORT
Practice Address - State:KY
Practice Address - Zip Code:42351-6701
Practice Address - Country:US
Practice Address - Phone:270-927-9991
Practice Address - Fax:270-927-9990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OWENSBORO MEDICAL PRACTICE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-17
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty