| NPI | 1427165869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES TODD DOUGLAS President/Owner 270-526-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 34188) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 7100116510) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-01-18 |