Sumrall, Michelle Jackson

Sumrall, Michelle Jackson is an individual health care provider with primary practice located at 1301 Ring Rd , Elizabethtown KY 42701-8968. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sumrall, Michelle Jackson can be contacted via phone (270) 765-2107.

Contact Information

Primary practice address
1301 Ring Rd Elizabethtown KY 42701-8968
Phone: (270) 765-2107
Fax: (270) 169-9642
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 37097 Kentucky

Profile Details

NPI number 1639158520
LBN Legal business name Sumrall, Michelle Jackson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Apr 24th, 2024 - about 7 months 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 1639158520 NPPES
Kentucky Other K182871 MEDICARE
Kentucky Other 000000225528 MEDICARE
Kentucky MEDICAID 300052072 MEDICARE
Kentucky MEDICAID 64049216 MEDICARE

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