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100 Providence Way Suite 200 Nicholasville KY 40356-6031 | |
(859) 260-5370 | |
(859) 260-5379 |
Full Name | |
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Speciality | Internal Medicine |
Location | 100 Providence Way, Nicholasville, Kentucky |
Authorized Official Name and Position | William Sisson (PRESIDENT) |
Authorized Official Contact | 8592606104 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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799 E Brannon Rd Nicholasville KY 40356-6038 Ph: (859) 260-5370 | 100 Providence Way Suite 200 Nicholasville KY 40356-6031 Ph: (859) 260-5370 |
NPI Number | 1285907352 |
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Provider Enumeration Date | 02/20/2012 |
Last Update Date | 07/31/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285907352 | NPI | - | NPPES |
7100073430 (MD GRP) | Medicaid | KY | |
7100099020 (PA GRP) | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
Kpa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 Keene Manor Cir, Nicholasville, KY 40356 Phone: 718-961-3277 | |
Peter Aliu Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Stable Way, Nicholasville, KY 40356 Phone: 276-233-9982 Fax: 859-687-0001 |