| NPI | 1417900242 |
|---|---|
| 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 | 122300000X Dentist |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-10-07 |