Basic Information
| Provider Information | |||||||||
| NPI: | 1467617423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUINTERO | ||||||||
| FirstName: | PAIGE | ||||||||
| MiddleName: | NEALY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4071 TATES CREEK CENTRE DR | ||||||||
| Address2: | STE 202 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405173094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704430202 | ||||||||
| FaxNumber: | 2704430235 | ||||||||
| Practice Location | |||||||||
| Address1: | 2501 KENTUCKY AVE | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420033813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704430202 | ||||||||
| FaxNumber: | 2704430235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2008 | ||||||||
| LastUpdateDate: | 12/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2013015509 | MO | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 125055417 | IL | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 47398 | KY | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.