| Advanced Internal Medicine Pllc | |
|
2005 Broadway St Paducah KY 42001-7107 | |
| (270) 366-7650 | |
| (270) 443-0660 |
| Full Name | Advanced Internal Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2005 Broadway St, Paducah, Kentucky |
| Authorized Official Name and Position | Ryan Curtis Frazine (SOLE MEMBER) |
| Authorized Official Contact | 2709942625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Internal Medicine Pllc 2005 Broadway St Paducah KY 42001-7107 Ph: (270) 366-7650 | Advanced Internal Medicine Pllc 2005 Broadway St Paducah KY 42001-7107 Ph: (270) 366-7650 |
| NPI Number | 1336563543 |
|---|---|
| Provider Enumeration Date | 02/07/2014 |
| Last Update Date | 12/29/2022 |
| Medicare PECOS PAC ID | 9537392154 |
|---|---|
| Medicare Enrollment ID | O20140507000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336563543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ryan C Frazine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548339070 PECOS PAC ID: 8426005240 Enrollment ID: I20050405000120 |
| Provider Name | Isaac R Mittendorf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528595352 PECOS PAC ID: 5597020941 Enrollment ID: I20200618003015 |
| Provider Name | Dalton T Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841914439 PECOS PAC ID: 8325415128 Enrollment ID: I20221108002104 |
Jeffrey L. Riney M.d. & Associates Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 225 Medical Center Dr, Suite 209b, Paducah, KY 42003 Phone: 270-441-4610 Fax: 270-441-4608 | |
Emerald Healthcare Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2520 New Holt Rd Ste I, Paducah, KY 42001 Phone: 270-558-3916 | |
Wilson Medical Staffing Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2603 Kentucky Ave Ste 305, Paducah, KY 42003 Phone: 270-558-5456 Fax: 270-558-5471 | |
Mercy Health Physicians Kentucky Specialty Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Medical Center Dr Ste 202, Paducah, KY 42003 Phone: 270-441-4510 Fax: 270-441-4512 | |
Western Baptist Medical Ventures, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Kentucky Ave, Paducah, KY 42003 Phone: 270-575-2101 Fax: 270-575-2905 | |
Infectious Diseases Associates Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1903 Broadway St, Paducah, KY 42001 Phone: 270-444-9889 Fax: 270-444-9291 | |
Baptist Health Prime Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 Kentucky Ave, Suite 103, Paducah, KY 42003 Phone: 270-443-4311 Fax: 270-443-4145 |