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10130 Cutshin Creek Rd. Yeaddiss KY 41777 | |
(606) 279-3850 | |
(606) 528-3871 |
Full Name | |
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Speciality | Clinic/Center |
Location | 10130 Cutshin Creek Rd., Yeaddiss, Kentucky |
Authorized Official Name and Position | Michael W Stanley (C.E.O.) |
Authorized Official Contact | 6065269005 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 Ph: (606) 526-9005 | 10130 Cutshin Creek Rd. Yeaddiss KY 41777 Ph: (606) 279-3850 |
NPI Number | 1811654890 |
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Provider Enumeration Date | 11/24/2021 |
Last Update Date | 06/28/2024 |
Certification Date | 06/28/2024 |
Medicare PECOS PAC ID | 3870654064 |
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Medicare Enrollment ID | O20220419002722 |
Identifier | Type | State | Issuer |
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1811654890 | NPI | - | NPPES |