Bluegrass Direct Primary Care | |
227 E Main St Georgetown KY 40324-1711 | |
(606) 424-3068 | |
Not Available |
Full Name | Bluegrass Direct Primary Care |
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Speciality | Family Medicine |
Location | 227 E Main St, Georgetown, Kentucky |
Authorized Official Name and Position | Colton Jayne (PHYSICIAN/ OWNER) |
Authorized Official Contact | 8597106300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Bluegrass Direct Primary Care 227 E Main St Georgetown KY 40324-1711 Ph: (606) 424-3068 | Bluegrass Direct Primary Care 227 E Main St Georgetown KY 40324-1711 Ph: (606) 424-3068 |
NPI Number | 1700582327 |
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Provider Enumeration Date | 02/06/2023 |
Last Update Date | 09/13/2023 |
Medicare PECOS PAC ID | 9335514173 |
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Medicare Enrollment ID | O20230410002391 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700582327 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Colton T. Jayne |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689108821 PECOS PAC ID: 8820347859 Enrollment ID: I20210107001897 |
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