Provider Demographics
NPI:1427161355
Name:PAM B. KOOB, PHD, ARNP DBA INTERNAL MEDICINE ASSOCIATES
Entity type:Organization
Organization Name:PAM B. KOOB, PHD, ARNP DBA INTERNAL MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOOB
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:270-885-5185
Mailing Address - Street 1:4241 FT CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240
Mailing Address - Country:US
Mailing Address - Phone:270-885-5185
Mailing Address - Fax:270-885-5187
Practice Address - Street 1:4241 FT CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240
Practice Address - Country:US
Practice Address - Phone:270-885-5185
Practice Address - Fax:270-885-5187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty