Provider Demographics
NPI:1467782466
Name:ADVANCED MEDICAL SERVICES
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:LEGREE
Authorized Official - Last Name:SHEMWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-345-1109
Mailing Address - Street 1:13003 TATTERSALL LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9718
Mailing Address - Country:US
Mailing Address - Phone:502-345-1109
Mailing Address - Fax:
Practice Address - Street 1:13003 TATTERSALL LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9718
Practice Address - Country:US
Practice Address - Phone:502-345-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY23426207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty