Provider Demographics
NPI:1831157528
Name:SHIBEN, ROSEMARY V (MD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:V
Last Name:SHIBEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7914
Mailing Address - Country:US
Mailing Address - Phone:270-441-4275
Mailing Address - Fax:270-441-4197
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4275
Practice Address - Fax:270-441-4197
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY334302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64334303Medicaid
KYCB6744OtherRR MEDICARE
G72023Medicare UPIN
KYCB6744OtherRR MEDICARE