Hazard Family Medical Clinic | |
625 Memorial Dr Ste 1 Hazard KY 41701-1380 | |
(606) 435-0001 | |
(606) 435-0058 |
Full Name | Hazard Family Medical Clinic |
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Speciality | Clinic/Center |
Location | 625 Memorial Dr Ste 1, Hazard, Kentucky |
Authorized Official Name and Position | Jonathan S Helton (OWNER) |
Authorized Official Contact | 6062338140 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hazard Family Medical Clinic 625 Memorial Drive Suite 1 Hazard KY 41701-1511 Ph: (606) 435-0001 | Hazard Family Medical Clinic 625 Memorial Dr Ste 1 Hazard KY 41701-1380 Ph: (606) 435-0001 |
NPI Number | 1023527678 |
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Provider Enumeration Date | 09/27/2017 |
Last Update Date | 03/07/2023 |
Medicare PECOS PAC ID | 7012283450 |
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Medicare Enrollment ID | O20171030001952 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023527678 | NPI | - | NPPES |
7100200180 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 3007238 (Kentucky) | Primary |
Provider Name | Jonathan Scott Helton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750658621 PECOS PAC ID: 4981863644 Enrollment ID: I20120315000598 |
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