East Side Family Medicine, Psc | |
601 Versailles Rd Frankfort KY 40601-3857 | |
(502) 695-3946 | |
(502) 695-3847 |
Full Name | East Side Family Medicine, Psc |
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Speciality | Family Medicine |
Location | 601 Versailles Rd, Frankfort, Kentucky |
Authorized Official Name and Position | Allen Courtney Haddix (PRESIDENT) |
Authorized Official Contact | 5026953946 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Side Family Medicine, Psc 601 Versailles Rd Frankfort KY 40601-3857 Ph: (502) 695-3946 | East Side Family Medicine, Psc 601 Versailles Rd Frankfort KY 40601-3857 Ph: (502) 695-3946 |
NPI Number | 1518073105 |
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Provider Enumeration Date | 08/23/2006 |
Last Update Date | 12/09/2011 |
Medicare PECOS PAC ID | 7719950914 |
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Medicare Enrollment ID | O20040816001449 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518073105 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Evan K Dicken |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1912050519 PECOS PAC ID: 0244330272 Enrollment ID: I20070705000322 |
Provider Name | Allen Courtney Haddix |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508933771 PECOS PAC ID: 1355314550 Enrollment ID: I20111003000314 |
Provider Name | Elizabeth D Todd |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043500036 PECOS PAC ID: 6901023845 Enrollment ID: I20180719003073 |
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