Provider Demographics
NPI:1174704829
Name:VALENTINI, GEORGE R (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:VALENTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4025
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-4025
Mailing Address - Country:US
Mailing Address - Phone:270-885-1140
Mailing Address - Fax:270-885-1183
Practice Address - Street 1:1724 KENTON ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1981
Practice Address - Country:US
Practice Address - Phone:270-885-1140
Practice Address - Fax:270-885-1183
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272092086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64272099Medicaid
KY64272099Medicaid
KY1540701Medicare PIN