| NPI | 1235131533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA HEADY Insurance & Billing COO Rdinator 270-745-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 36233) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 30097) |
| 363L00000X Nurse Practitioner (Licence: KY 1041583) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2008-01-18 |