NPI | 1881938363 |
---|---|
Entity Type | Organization |
Authorized Contact | L.M. (MIKE) CAUDILL Chief Executive Officer 606-633-4823 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2012-11-21 |
Last Update Date | 2024-10-07 |