MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES

LONDON, KY
NPI1710951116
Entity TypeOrganization
Authorized ContactKANDI R REA
Credentialing Specialist
606-330-7808
Organization Subpart ?No
Primary Taxonomy207L00000X Anesthesiology
Additional Taxonomies207Q00000X Family Medicine
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
207RP1001X Internal Medicine, Pulmonary Disease
2080A0000X Pediatrics, Adolescent Medicine
2084N0400X Psychiatry & Neurology, Neurology
2085R0202X Radiology, Diagnostic Radiology
208600000X Surgery
(Licence: KY  40293)
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
208M00000X Hospitalist
207X00000X Orthopaedic Surgery
363LF0000X Nurse Practitioner, Family
363AS0400X Physician Assistant, Surgical
261QR1300X Clinic/Center, Rural Health
213ES0103X Podiatrist, Foot & Ankle Surgery
Enumeration Date2006-02-14
Last Update Date2011-06-13
Business Address
MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
1001 SAINT JOSEPH LANE
LONDON, KY 40741-8345
Phone number: 606-330-6000
Mailing Address
MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
740 E LAUREL RD
LONDON, KY 40741-8601
Phone number: 606-330-7808