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200 Medical Center Dr Hazard KY 41701-9466 | |
| (606) 439-6600 | |
| (606) 439-6953 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Medical Center Dr, Hazard, Kentucky |
| Authorized Official Name and Position | Hollie P. Harris (PRESIDENT AND CEO) |
| Authorized Official Contact | 8592262511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
200 Medical Center Drive Hazard KY 41701 Ph: (606) 439-6600 | 200 Medical Center Dr Hazard KY 41701-9466 Ph: (606) 439-6600 |
| NPI Number | 1558431346 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 09/20/2024 |
| Certification Date | 09/20/2024 |
| Medicare PECOS PAC ID | 0840107835 |
|---|---|
| Medicare Enrollment ID | O20210707000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558431346 | NPI | - | NPPES |
| 65901712 | Medicaid | KY |
| Provider Name | Arvind Vasudevan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770503526 PECOS PAC ID: 2860414091 Enrollment ID: I20170530001327 |
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