Basic Information
| Provider Information | |||||||||
| NPI: | 1013113745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORE | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 614 | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422410614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708862205 | ||||||||
| FaxNumber: | 2708860392 | ||||||||
| Practice Location | |||||||||
| Address1: | 737B NORTH DRIVE | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708901780 | ||||||||
| FaxNumber: | 2708901789 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 11/23/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0802X | 40996 | KY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 7100129750 | 05 | KY | MEDICAID |