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2412 Ring Rd Suite 200 Elizabethtown KY 42701-7998 | |
| (270) 765-5926 | |
| (270) 763-0051 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2412 Ring Rd, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Thomas G Ingram (OWNER) |
| Authorized Official Contact | 2707655926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2412 Ring Rd Suite 200 Elizabethtown KY 42701-7998 Ph: (270) 765-5926 | 2412 Ring Rd Suite 200 Elizabethtown KY 42701-7998 Ph: (270) 765-5926 |
| NPI Number | 1396750022 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 05/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396750022 | NPI | - | NPPES |
| 65940306 | Medicaid | KY | |
| DB3908 | Other | KY | RAILROAD MEDICARE GRP # |
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