| Full Name | |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 117 E Main St, Salem, Kentucky |
| Authorized Official Name and Position | Misty Kay Mckinney (CONTROLLER) |
| Authorized Official Contact | 2709651001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
117 E Main St Salem KY 42078-9998 Ph: (270) 988-3839 | 117 E Main St Salem KY 42078 Ph: (270) 988-3839 |
| NPI Number | 1265481022 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 07/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265481022 | NPI | - | NPPES |
| 35001981 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 900061 (Kentucky) | Primary |
| 261QR1300X | Clinic/center - Rural Health | 900061 (Kentucky) | Secondary |
R V Bharne Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 N Hayden Avenue, Salem, KY 42078 Phone: 270-988-3399 |