Provider Demographics
NPI:1144483835
Name:SALLEE, JOHN MUIR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MUIR
Last Name:SALLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 480W
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-761-0043
Mailing Address - Fax:270-752-2853
Practice Address - Street 1:719 ELM ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2638
Practice Address - Country:US
Practice Address - Phone:270-761-0043
Practice Address - Fax:270-752-2853
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY437532084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100166820Medicaid
KY7100166820Medicaid