Provider Demographics
NPI:1568807360
Name:ELK CREEK ANIMAL HOSPITAL
Entity Type:Organization
Organization Name:ELK CREEK ANIMAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERINARIAN/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:502-477-1477
Mailing Address - Street 1:57 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40023-6412
Mailing Address - Country:US
Mailing Address - Phone:502-477-1477
Mailing Address - Fax:502-477-1478
Practice Address - Street 1:57 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:FISHERVILLE
Practice Address - State:KY
Practice Address - Zip Code:40023-6412
Practice Address - Country:US
Practice Address - Phone:502-477-1477
Practice Address - Fax:502-477-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNSKY3663284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital