| NPI | 1851484778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL WATTS Vice President 606-528-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-11-03 |