| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SAMANTHA OCTAVIA EVERSOLE | 1467184879 | 2022-06-26 |
Samantha Octavia Eversole is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1467184879. Registration indicates Samantha Octavia Eversole is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Samantha Octavia Eversole DO |
| Practice Office Address | 240 HOSPITAL RD WHITESBURG, KY US |
| Practice Office Telephone | 6066333500 |
| Mailing Address | 73 RALEIGH RD CHAVIES, KY 417279049 US |
| Business Telephone | 6062165640 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |