Provider Demographics
NPI:1861650699
Name:STEVEN C APPLEGATE PSC
Entity Type:Organization
Organization Name:STEVEN C APPLEGATE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:APPLEGATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-241-8611
Mailing Address - Street 1:304 MOUNT MERCY DR
Mailing Address - Street 2:
Mailing Address - City:PEWEE VALLEY
Mailing Address - State:KY
Mailing Address - Zip Code:40056-8020
Mailing Address - Country:US
Mailing Address - Phone:502-241-8611
Mailing Address - Fax:502-241-4175
Practice Address - Street 1:304 MOUNT MERCY DR
Practice Address - Street 2:
Practice Address - City:PEWEE VALLEY
Practice Address - State:KY
Practice Address - Zip Code:40056-8020
Practice Address - Country:US
Practice Address - Phone:502-241-8611
Practice Address - Fax:502-241-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64226392Medicaid
KYC68742Medicare UPIN
KY00647001Medicare PIN
KYZ3W3Medicare PIN