| NPI | 1295104800 |
|---|---|
| Doing Business As | COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD G SOWELL Executive Vice President 270-745-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2015-09-24 |