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1015 N 3rd St Bardstown KY 40004-2616 | |
(502) 331-0301 | |
(502) 331-0301 |
Full Name | |
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Speciality | Clinic/center |
Location | 1015 N 3rd St, Bardstown, Kentucky |
Authorized Official Name and Position | Robert Ben Burgett (PRESIDENT) |
Authorized Official Contact | 5023310301 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1015 N 3rd St Bardstown KY 40004-2616 Ph: (502) 331-0301 | 1015 N 3rd St Bardstown KY 40004-2616 Ph: (502) 331-0301 |
NPI Number | 1609063981 |
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Provider Enumeration Date | 10/01/2007 |
Last Update Date | 10/01/2007 |
Identifier | Type | State | Issuer |
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1609063981 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 4639 (Kentucky) | Primary |
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