LILY CREEK MEDICAL GROUP, PSC

RUSSELL SPRINGS, KY
NPI1205987542
Entity TypeOrganization
Authorized ContactROBERT L. BERTRAM
President
270-866-8881
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies363LF0000X Nurse Practitioner, Family
363L00000X Nurse Practitioner
Enumeration Date2007-01-15
Last Update Date2008-10-30
Business Address
LILY CREEK MEDICAL GROUP, PSC
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642-8543
Phone number: 270-866-8881
Mailing Address
LILY CREEK MEDICAL GROUP, PSC
PO BOX 5007
FRANKFORT, KY 40602-5007
Phone number: 502-226-3858