Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 02004559A | IN |
N | 207Q00000X | Family Doctor | 04039 | KY |
N | 207Q00000X | Family Doctor | 11016792A | IN |
Y | 207QS0010X | Family Doctor - Sports Medicine | 04039 | KY |
NPI | 1003170713 |
---|---|
Provider Name | Dr. Joseph Tylor Silvers |
First Address | London, KY 40743-0936 |
Second Address | Corbin, KY 40701-4819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2012 |
Last Update Date | 08/03/2021 |