Provider Demographics
NPI:1689879405
Name:NOE, STEPHEN B (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
Last Name:NOE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-489-5730
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:95 BRYAN BLVD
Practice Address - Street 2:STE 201
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2788
Practice Address - Country:US
Practice Address - Phone:606-526-4590
Practice Address - Fax:606-526-0548
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2015-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYPA788363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPA788OtherPA LICENSE