| NPI | 1568710762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L.M. (MIKE) CAUDILL CEO 606-633-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 363A00000X Physician Assistant | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2021-07-06 |