| NPI | 1134213101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN J O'DELL Owner 606-833-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 28279) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-04-30 |