Provider Demographics
NPI:1376557298
Name:C LANCE LOVE MD PLLC
Entity Type:Organization
Organization Name:C LANCE LOVE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:C.
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-885-8506
Mailing Address - Street 1:1724 KENTON ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1981
Mailing Address - Country:US
Mailing Address - Phone:270-885-8505
Mailing Address - Fax:270-885-8564
Practice Address - Street 1:1724 KENTON ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1981
Practice Address - Country:US
Practice Address - Phone:270-885-8505
Practice Address - Fax:270-885-8564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty