| Estill Medical Clinic, Psc | |
|
275 Court St Irvine KY 40336-1077 | |
| (606) 723-2167 | |
| (606) 723-2112 |
| Full Name | Estill Medical Clinic, Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 275 Court St, Irvine, Kentucky |
| Authorized Official Name and Position | Donna R Isfort (OWNER) |
| Authorized Official Contact | 6067232167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Estill Medical Clinic, Psc 275 Court St Irvine KY 40336-1077 Ph: (606) 723-2167 | Estill Medical Clinic, Psc 275 Court St Irvine KY 40336-1077 Ph: (606) 723-2167 |
| NPI Number | 1154500296 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 11/09/2011 |
| Medicare PECOS PAC ID | 5597845255 |
|---|---|
| Medicare Enrollment ID | O20080108000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154500296 | NPI | - | NPPES |
| 000000507512 | Other | KY | ANTHEM |
| 64142649 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Donna Ruth Isfort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972684215 PECOS PAC ID: 3375568223 Enrollment ID: I20051010000668 |
| Provider Name | Dustin K Devers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699989640 PECOS PAC ID: 7214038538 Enrollment ID: I20070730000908 |
| Provider Name | Elizabeth J Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215168349 PECOS PAC ID: 1153477906 Enrollment ID: I20090918000339 |
| Provider Name | Tamara E. Carey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366991424 PECOS PAC ID: 9234418948 Enrollment ID: I20161121002736 |
| Provider Name | Nicole Rae Mcnees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528640364 PECOS PAC ID: 7719374354 Enrollment ID: I20220428001225 |
| Provider Name | Elaine Fredrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972564433 PECOS PAC ID: 2769675743 Enrollment ID: I20220523002565 |
| Provider Name | Shelbi L Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497473029 PECOS PAC ID: 2860877107 Enrollment ID: I20220922001124 |
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