Dennison, Melissa Boucher

Dennison, Melissa Boucher is an individual health care provider with primary practice located at 301 Professional Park Dr , Glasgow KY 42141-3487. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dennison, Melissa Boucher can be contacted via phone (270) 651-9696.

Contact Information

Primary practice address
301 Professional Park Dr Glasgow KY 42141-3487
Phone: (270) 651-9696
Fax: (270) 651-0385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X KY28593 Kentucky

Profile Details

NPI number 1659354892
LBN Legal business name Dennison, Melissa Boucher
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated May 5th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659354892 NPPES
Kentucky MEDICAID 64285935

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