| NPI | 1154394294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA C. BROCK Business Manager 270-651-9611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 18627) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2011-11-22 |