| NPI | 1386781789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAWNTAY GILMORE Office Manager 606-523-5402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 174400000X Specialist | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2017-10-06 |