Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 29510 | KY |
NPI | 1891833380 |
---|---|
Provider Name | Dr. Ronald Everson |
First Address | Versailles, KY 40383-8815 |
Second Address | Shelbyville, KY 40065-7791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 23/06/2020 |