| Hospitalist Medicine Physicians Of Kentucky - Berea, Psc | |
|
1210 Ky Highway 36 E Unit 1 Cynthiana KY 41031-7665 | |
| (615) 377-5658 | |
| Not Available |
| Full Name | Hospitalist Medicine Physicians Of Kentucky - Berea, Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1210 Ky Highway 36 E Unit 1, Cynthiana, Kentucky |
| Authorized Official Name and Position | Shannon Lagrone (DIRECTOR PAYER ENROLLMENT) |
| Authorized Official Contact | 2144225715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospitalist Medicine Physicians Of Kentucky - Berea, Psc 5410 Maryland Way Ste 300 Brentwood TN 37027-5339 Ph: (615) 377-5658 | Hospitalist Medicine Physicians Of Kentucky - Berea, Psc 1210 Ky Highway 36 E Unit 1 Cynthiana KY 41031-7665 Ph: (615) 377-5658 |
| NPI Number | 1003664574 |
|---|---|
| Provider Enumeration Date | 05/09/2024 |
| Last Update Date | 05/14/2024 |
| Medicare PECOS PAC ID | 2961948211 |
|---|---|
| Medicare Enrollment ID | O20240723000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003664574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James O Calder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447667332 PECOS PAC ID: 0244545788 Enrollment ID: I20180830003707 |
| Provider Name | Erik Quintero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003480781 PECOS PAC ID: 4284033887 Enrollment ID: I20221017001337 |
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