| NPI | 1023415601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNA R JONES Owner/Provider 270-821-6262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 42115) |
| 207Q00000X Family Medicine (Licence: KY 43637) | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2019-05-16 |