| NPI | 1063645158 |
|---|---|
| Doing Business As | SOUTHERN KY MEDICAL ASSOCIATION |
| Entity Type | Organization |
| Authorized Contact | ANGIE CUNDIFF-ROY Owner 270-507-6088 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |