Paul Christen Pedersen
General Practice Physician
602 Knox St
Barbourville
, Kentucky 40906-1304
Paul Christen Pedersen
General Practice Physician
602 Knox St
Barbourville
, Kentucky 40906-1304
(606) 528-8661
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Paul Christen Pedersen
- Po Box 1325
- Corbin, KY
- Zip : 40702-1325
- Fax : (606) 528-8661
- Phone : (606) 526-8131
Second Address
- Paul Christen Pedersen
- 602 Knox St
- Barbourville, KY
- Zip : 40906-1304
- Fax : (606) 546-2084
- Phone : (606) 546-6027
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | 31705 | KY |
National Provider Identifier
| NPI | 1003892720 |
|---|---|
| Provider Name | Paul Christen Pedersen |
| First Address | Corbin, KY 40702-1325 |
| Second Address | Barbourville, KY 40906-1304 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/12/2005 |
| Last Update Date | 07/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 64317050 | (05) | KY |
| P01427263 | RR MEDICARE (01) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.