DR. GREGORY V HAZELETT (NPI# 1639171390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639171390 |
| Entity Type | Individual |
| Full Name | DR. GREGORY V HAZELETT |
| Credential | D.O. |
| Practice Address |
911 Bypass Rd 9th Floor Clinic Pikeville KY 41501-1689 |
| Mailing Address |
Po Box 2917 Pikeville KY 41502-2917 |
| Practice Telephone | 6062181000 |
| Practice Fax Number | 6062184562 |
| Mailing Telephone | 6062183500 |
| Mailing Fax Number | 6062184562 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2015-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 02303 | KY | Allopathic & Osteopathic Physicians |
| Y | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
02303 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 040016966 | 01 | |
| KY | 64023039 | 05 | |
| KY | TAX ID | 611393689 | 01 |
| Street Address |
911 BYPASS RD 9TH FLOOR CLINIC |
| City | PIKEVILLE |
| State | KY |
| Zip Code | 41501-1689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345045 | Trevor Jones | Nurse Practitioner | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2005-06-09 |
| 1134736564 | Matthew Gene Damron | Pharmacist | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2020-09-29 |
| 1164051090 | Keterah F Norman | Respiratory Therapist, Registered | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2020-04-03 |
| 1144887951 | William Albert Ison | Nurse Practitioner | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2019-05-28 |
| 1598226045 | Joshua Adam Mullins | Family Medicine | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2019-03-27 |
| 1801360623 | Ryan Anthony Preston | Nurse Anesthetist, Certified Registered | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2019-01-15 |
| 1710486162 | Shylebra Lea Holbrook | Nurse Practitioner | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2018-02-12 |
| 1124530878 | Cynthia Acosta Pence | Nurse Practitioner | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2017-11-02 |
| 1598276552 | John Andrew Schultz | Nurse Anesthetist, Certified Registered | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2017-10-18 |
| 1053820555 | Samantha Boyd | Physician Assistant | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2017-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720634 | Lauren Ann Thacker | Nurse Practitioner | 648 Stonehenge Drive, Pikeville, KY 41501 | 2020-11-03 |
| 1659933406 | Wesley Tyler Rowe | Pharmacist | 553 Hambley Boulevard, Suite 6, Pikeville, KY 41501 | 2019-07-02 |
| 1275096489 | Eric Taejun Kim | Student in an Organized Health Care Education/Training Program | 184 South Mayo Trail, Pikeville, KY 41501 | 2019-04-13 |
| 1245755206 | Paula Renee Belcher | Nurse Practitioner | 5724 E Shelbiana Road, Pikeville, KY 41501 | 2017-08-10 |
| 1174044390 | Jessie C Deffendall | Dentist | 220 Cassidy Blvd, Pikeville, KY 41501 | 2017-06-28 |
| 1942667456 | Crossroads Addiction Recovery Effort, LLC | Family Medicine | 484 Tollage Crk, Pikeville, KY 41501 | 2016-01-28 |
| 1265836183 | Rebecca Leann Roberts | Pharmacist | 259 Bear Rd, Pikeville, KY 41501 | 2014-10-21 |
| 1306253190 | Ginger Webb Aprn | Clinic/Center | 153 Weddington Branch Rd., Pikeville, KY 41501 | 2014-07-14 |
| 1710323894 | Bhg Xxv, LLC | Case Management | 368 South Mayo Trail, Pikeville, KY 41501 | 2013-05-16 |
| 1740624220 | Sunrise Children's Services, Inc. | Foster Care Agency | 123 Weddington Branch Road, Pikeville, KY 41501 | 2013-04-26 |
| Find all providers in zip 41501 | ||||
| Taxonomy Code | 207YX0602X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngic Allergy |
| An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194771592 | Kentuckiana Ear, Nose & Throat Psc | Otolaryngology | 6420 Dutchmans Pkwy Ste 380, Louisville, KY 40205-3355 | 2006-05-26 |
| 1750381091 | Patricia A Murphy | Otolaryngology | 221 Highway 15 S, Jackson, KY 41339-9600 | 2005-07-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.