| NPI | 1801928189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI W. BUTLER Office Manager 270-443-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 29692) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA443) |
| 363L00000X Nurse Practitioner (Licence: KY 2980P) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2014-11-25 |