1033053285 NPI number — DR. CALEB JOSEPH SEDLAK MD

Table of content: DR. CALEB JOSEPH SEDLAK MD (NPI 1033053285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033053285 NPI number — DR. CALEB JOSEPH SEDLAK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEDLAK
Provider First Name:
CALEB
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033053285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UOFL/OWENSBORO FAMILY MEDICINE RESIDENCY
Provider Second Line Business Mailing Address:
811 E. PARRISH AVE, SUITE 102
Provider Business Mailing Address City Name:
OWENSBORO
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-523-7370
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UOFL/OWENSBORO FAMILY MEDICINE RESIDENCY 811 E. PARRISH
Provider Second Line Business Practice Location Address:
AVE, SUITE 102
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-688-1228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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