| Integra Healthcare Associates | |
|
4071 Tates Creek Centre Dr Ste 101 Lexington KY 40517-3063 | |
| (859) 396-3050 | |
| Not Available |
| Full Name | Integra Healthcare Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 4071 Tates Creek Centre Dr Ste 101, Lexington, Kentucky |
| Authorized Official Name and Position | Alicia O Gatterdam (MEMBER) |
| Authorized Official Contact | 2402718962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integra Healthcare Associates 4108 Clearwater Way Lexington KY 40515-6000 Ph: (859) 396-3050 | Integra Healthcare Associates 4071 Tates Creek Centre Dr Ste 101 Lexington KY 40517-3063 Ph: (859) 396-3050 |
| NPI Number | 1134723919 |
|---|---|
| Provider Enumeration Date | 11/23/2020 |
| Last Update Date | 01/31/2023 |
| Medicare PECOS PAC ID | 7012375157 |
|---|---|
| Medicare Enrollment ID | O20230621002209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134723919 | NPI | - | NPPES |
| Provider Name | William G Devine |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699745646 PECOS PAC ID: 2466433321 Enrollment ID: I20040602000699 |
| Provider Name | Alicia O Gatterdam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972022150 PECOS PAC ID: 8921364936 Enrollment ID: I20171108000250 |
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