Basic Information
| Provider Information | |||||||||
| NPI: | 1891415972 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENNIE STUART MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2400 | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422412400 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 W 18TH ST | ||||||||
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| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422401963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708864625 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2022 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | AUTUMN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PFS AND MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 2708870100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.