| NPI | 1083805931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SMITH Office Manager 606-451-0312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2017-05-16 |