| NPI | 1376946913 |
|---|---|
| Doing Business As | COMMUNITY PHYSICIAN GROUP |
| Entity Type | Organization |
| Authorized Contact | TERRANCE DILLON Assistant Secretary 502-596-7220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2022-04-22 |