Provider Demographics
NPI:1982601399
Name:FINE, JOSEPH G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:FINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7906
Mailing Address - Fax:615-920-8775
Practice Address - Street 1:8 LINVILLE DR
Practice Address - Street 2:SUITE B
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2128
Practice Address - Country:US
Practice Address - Phone:859-987-1195
Practice Address - Fax:859-987-1107
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22706208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64227069Medicaid
KYC66088Medicare UPIN
KY64227069Medicaid
KY00637048Medicare PIN