| NPI | 1629740774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANYEL D CLAY Vice President, Rev Cycle & Coding 502-253-4911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |