Provider Demographics
NPI:1932303294
Name:BALLARD COUNTY MEDICAL CENTER PSC
Entity Type:Organization
Organization Name:BALLARD COUNTY MEDICAL CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HARPOLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:270-534-8999
Mailing Address - Street 1:PO BOX 7287
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7287
Mailing Address - Country:US
Mailing Address - Phone:270-534-8999
Mailing Address - Fax:270-534-1670
Practice Address - Street 1:120 S 4TH ST
Practice Address - Street 2:
Practice Address - City:BARLOW
Practice Address - State:KY
Practice Address - Zip Code:42024
Practice Address - Country:US
Practice Address - Phone:270-534-8999
Practice Address - Fax:270-534-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty