| NPI | 1184805160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA J SUTTON Member 502-479-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KY 34205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 34205) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |