Provider Demographics
NPI:1891891776
Name:EAR NOSE & THROAT GROUP PSC
Entity Type:Organization
Organization Name:EAR NOSE & THROAT GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:COZART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-575-0079
Mailing Address - Street 1:2601 KENTUCKY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003
Mailing Address - Country:US
Mailing Address - Phone:270-575-0079
Mailing Address - Fax:270-575-0735
Practice Address - Street 1:2601 KENTUCKY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-575-0079
Practice Address - Fax:270-575-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty