| Organization Name: | OWENSBORO HEALTH MEDICAL GROUP, INC |
| NPI Number: | 1013353101 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN T HACKBARTH (SECRETARY) |
| Mailing Address: | 2211 Mayfair Dr Suite 409 Owensboro |
| State: | KY US |
| Postal Code: | 423014568 |
| Phone Number: | 2704177980 |
| Fax Number: | 2704177989 |
| NPI Enumeration Date: | 05/15/2013 |
| NPI Last Update Date: | 12/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |