Provider Demographics
NPI:1588694491
Name:RECTOR, SHEILA DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:DAWN
Last Name:RECTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHEILA
Other - Middle Name:DAWN
Other - Last Name:RECTOR-NUCKOLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2552 HILLBROOKE PKWY
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4502
Mailing Address - Country:US
Mailing Address - Phone:270-684-3865
Mailing Address - Fax:
Practice Address - Street 1:2552 HILLBROOKE PKWY
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4502
Practice Address - Country:US
Practice Address - Phone:270-684-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24643207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0521402Medicaid
SCC72570Medicare UPIN
SC0521402Medicaid