| NPI | 1316991979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L.M. (MIKE) CAUDILL Chief Executive Officer 606-633-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-10-07 |