Full Name | |
---|---|
Speciality | Family Medicine |
Location | 96 Hwy 80, Hyden, Kentucky |
Authorized Official Name and Position | Connie L. Hubbard (RISK MANAGER) |
Authorized Official Contact | 6066721102 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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96 Hwy 80 Hurts Creek Center P.o. Box 680 Hyden KY 41749-8500 Ph: (606) 672-1102 | 96 Hwy 80 Hyden KY 41749-8500 Ph: (606) 672-1419 |
NPI Number | 1083630909 |
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Provider Enumeration Date | 07/14/2006 |
Last Update Date | 04/07/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083630909 | NPI | - | NPPES |
35001874 | Medicaid | KY | |
9615 | Other | KY MCR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |