| Family Practice Clinic Of Booneville, Inc. | |
|
200 Mulberry St Suite A Booneville KY 41314-7505 | |
| (606) 593-6023 | |
| (606) 593-6087 |
| Full Name | Family Practice Clinic Of Booneville, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Mulberry St, Booneville, Kentucky |
| Authorized Official Name and Position | Kim Cox (OWNER OPERATOR) |
| Authorized Official Contact | 6065936023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Clinic Of Booneville, Inc. Po Box 737 200 Mulberry Street, Suite A Booneville KY 41314-0737 Ph: (606) 593-6023 | Family Practice Clinic Of Booneville, Inc. 200 Mulberry St Suite A Booneville KY 41314-7505 Ph: (606) 593-6023 |
| NPI Number | 1326152109 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 12/22/2015 |
| Medicare PECOS PAC ID | 6406764612 |
|---|---|
| Medicare Enrollment ID | O20021210000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326152109 | NPI | - | NPPES |
| 7100159610 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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