Sivoravong, Jon C

Sivoravong, Jon C is an individual health care provider with primary practice located at 811 E Parrish Ave , Owensboro KY 42303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sivoravong, Jon C can be contacted via phone (270) 691-8040.

Contact Information

Primary practice address
811 E Parrish Ave Owensboro KY 42303
Phone: (270) 691-8040
Fax: (270) 691-8049
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X J6729 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 04419 Kentucky

Profile Details

NPI number 1770545238
LBN Legal business name Sivoravong, Jon C
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Nov 27th, 2023 - about last year

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 1770545238 NPPES
Texas MEDICAID 124874202
Texas MEDICAID 300021015
Texas MEDICAID 7100572080
Texas Other 080112014
Texas Other 847571

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