| NPI | 1316997067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF D KINGERY Director 270-706-1046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA241) |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2009-09-17 |