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703 Mcdowell Blvd Suite 100 Bardstown KY 40004-2651 | |
(502) 349-1212 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 703 Mcdowell Blvd, Bardstown, Kentucky |
Authorized Official Name and Position | Hugh Hall (PHYSICIAN/OWNER) |
Authorized Official Contact | 5023491212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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703 Mcdowell Blvd Suite 100 Bardstown KY 40004-2651 Ph: (502) 349-1212 | 703 Mcdowell Blvd Suite 100 Bardstown KY 40004-2651 Ph: (502) 349-1212 |
NPI Number | 1952358707 |
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Provider Enumeration Date | 05/27/2006 |
Last Update Date | 09/20/2010 |
Medicare PECOS PAC ID | 4880739747 |
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Medicare Enrollment ID | O20100303000123 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952358707 | NPI | - | NPPES |
000000050161 | Other | KY | ANTHEM |
1055781 | Other | KY | PASSPORT |
64269301 | Medicaid | KY | |
726778 | Other | KY | HUMANA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 26930 (Kentucky) | Primary |
Provider Name | Hugh Hall |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457533846 PECOS PAC ID: 4183769383 Enrollment ID: I20100226000181 |
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