| |
302 Micbeth Dr Princeton KY 42445-6332 | |
(270) 365-1225 | |
(270) 365-1252 |
Full Name | |
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Speciality | Clinic/Center |
Location | 302 Micbeth Dr, Princeton, Kentucky |
Authorized Official Name and Position | Micah Beth Conger (OFFICIER) |
Authorized Official Contact | 2703650320 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 410 Princeton KY 42445-0410 Ph: (270) 365-1225 | 302 Micbeth Dr Princeton KY 42445-6332 Ph: (270) 365-1225 |
NPI Number | 1992286207 |
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Provider Enumeration Date | 08/24/2018 |
Last Update Date | 08/24/2018 |
Medicare PECOS PAC ID | 0749275014 |
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Medicare Enrollment ID | O20181003003526 |
Identifier | Type | State | Issuer |
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1992286207 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Kentucky) | Primary |
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