| NPI | 1609871581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY SHEPHERD Office Manager 606-528-4481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 20474,23298,32248) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-07-17 |