Unknown Individual – Internal Medicine Physician, NPI 1003838707

Unknown Individual is a healthcare provider. based in Paducah, Kentucky. specializing in Internal Medicine Physician. They hold a License No. 35073 (KY). The NPI Number for Unknown Individual is 1003838707

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003838707
Phone
(270) 443-6543
Address
544 LONE OAK RD
Deactivation Date
9 November 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
2705752100
Graduation Year
1996 (30 years ago)
PAC ID
6305028499
Group Practice PAC ID
0042307852
Professional Enrollment ID
I20110310000594
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 544, Lone Oak Road, Forest Hill, Paducah, McCracken County, Kentucky, 42003, United States

    PADUCAH, KY 420034538

    Phone: (270) 443-6543

    Fax: (270) 442-3312

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42003)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042307852View full group profile
NameSpecialtyState
Family Practice, Geriatric MedicineKY
Internal MedicineNY
Emergency Medicine, Internal MedicineMS
-MO
Family Practice, Hospitalist, Family PracticeFL
Internal MedicineTN
Internal MedicineSC
Internal MedicineNC
-TN
Nurse PractitionerTN

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1003838707.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Paducah, Kentucky. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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