NPI | 1821416454 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA L STEPHENS Office Manager 606-789-4949 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 26513) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA804) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2022-07-21 |