| NPI | 1366539223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA JO EADENS Physician/Office Manager 606-451-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-02-16 |