Unknown Individual – Psychiatry Physician, NPI 1104876192
Psychiatry Physician
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NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 1078
CAMPBELLSVILLE, KY 427191078
Phone: (270) 465-2023
Fax: (270) 465-9630
Type: Mailing
1320, East Broadway Street, Campbellsville, Taylor County, Kentucky, 42718, United States
STE A
CAMPBELLSVILLE, KY 427181596
Phone: (270) 465-2023
Fax: (270) 465-9630
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 125 | 64 | $0 |
Insurance plans in this area (ZIP 42719)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KY | |
| - | KY | |
| - | KY | |
| - | KY | |
| Clinical Psychologist | KY | |
| - | KY | |
| - | KY | |
| Clinical Social Worker | KY | |
| - | CA | |
| - | KY |
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