Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 002242 | KY |
N | 2251H1200X | Hand | 002242 | KY |
NPI | 1285814145 |
---|---|
Provider Name | Dr. Beth Underwood Coon |
First Address | Versailles, KY 40383-1911 |
Second Address | Versailles, KY 40383-1911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 24/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000540474 | BCBS (01) | KY |
20-4579943 | HUMANA (01) | KY |
611938100 | US DEPT OF LABOR WC (01) | KY |
7311873 | AETNA (01) | KY |