Shively, Eugene Herman

Shively, Eugene Herman is an individual health care provider with primary practice located at 1698 Old Lebanon Rd Suite 2A, Campbellsville KY 42718-9662. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Shively, Eugene Herman can be contacted via phone (270) 465-2821.

Contact Information

Primary practice address
1698 Old Lebanon Rd Suite 2A Campbellsville KY 42718-9662
Phone: (270) 465-2821
Fax: (270) 789-1756
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 15931 Kentucky

Profile Details

NPI number 1396720132
LBN Legal business name Shively, Eugene Herman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Sep 20th, 2007 - about 19 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 1396720132 NPPES
Kentucky MEDICAID 64159312

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