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1463 Campbellsville Rd Columbia KY 42728-2263 | |
(270) 384-9934 | |
(270) 384-2823 |
Full Name | |
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Speciality | Family Medicine |
Location | 1463 Campbellsville Rd, Columbia, Kentucky |
Authorized Official Name and Position | Willow Rouben (CFO) |
Authorized Official Contact | 2703849934 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1463 Campbellsville Rd Columbia KY 42728-2263 Ph: (270) 384-9934 | 1463 Campbellsville Rd Columbia KY 42728-2263 Ph: (270) 384-9934 |
NPI Number | 1730243858 |
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Provider Enumeration Date | 12/21/2006 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 4082524822 |
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Medicare Enrollment ID | O20031217000826 |
Identifier | Type | State | Issuer |
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1730243858 | NPI | - | NPPES |
35001239 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Kentucky) | Primary |
Provider Name | Mary Dene |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669411849 PECOS PAC ID: 8921905456 Enrollment ID: I20031215000162 |
Provider Name | Robert S Shipp |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1629157235 PECOS PAC ID: 7911806492 Enrollment ID: I20040105000006 |
Provider Name | Sandra F Popplewell |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801171640 PECOS PAC ID: 2567638463 Enrollment ID: I20171003005655 |
T J Health Columbia Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 901 Westlake Dr, Columbia, KY 42728 Phone: 270-384-4753 Fax: 270-384-6228 | |
Grant Chiropractic Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 908 Russell Rd, Columbia, KY 42728 Phone: 270-384-3271 Fax: 270-384-3271 |