| NPI | 1699027862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY CONNETT Director Of Finance 606-833-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363LF0000X Nurse Practitioner Family | |
| 363A00000X Physician Assistant (Licence: KY PA1692) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2019-05-17 |