NPI | 1902323009 |
---|---|
Doing Business As | CLARK MEMORIAL CLINIC CONNECTION |
Entity Type | Organization |
Authorized Contact | SHELLEY GAST VP Managed Care 502-272-5335 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
363L00000X Nurse Practitioner | |
Enumeration Date | 2017-08-29 |
Last Update Date | 2023-11-07 |