Full Name | |
---|---|
Speciality | Family Medicine |
Location | Hc 75 Box 1005, Vanceburg, Kentucky |
Authorized Official Name and Position | Ronda Fay Stone (OFFICE MANAGER) |
Authorized Official Contact | 6067960010 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Hc 75 Box 1005 Vanceburg KY 41179 Ph: (606) 796-0010 | Hc 75 Box 1005 Vanceburg KY 41179 Ph: (606) 796-0010 |
NPI Number | 1750320446 |
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Provider Enumeration Date | 06/06/2006 |
Last Update Date | 07/07/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750320446 | NPI | - | NPPES |
64318454 | Medicaid | KY | |
000000043092 | Other | ANTHEM | |
P00224066 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 31845 (Kentucky) | Primary |