| Kentucky Accident & Injury Care Pllc | |
|
504 North Hwy 27 Somerset KY 42503-5706 | |
| (606) 667-0101 | |
| Not Available |
| Full Name | Kentucky Accident & Injury Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 504 North Hwy 27, Somerset, Kentucky |
| Authorized Official Name and Position | Larry L Oteham (OWNER/PROVIDER) |
| Authorized Official Contact | 6066670101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Accident & Injury Care Pllc 718 Lake Drive Ln La Follette TN 37766-5706 Ph: (901) 230-1185 | Kentucky Accident & Injury Care Pllc 504 North Hwy 27 Somerset KY 42503-5706 Ph: (606) 667-0101 |
| NPI Number | 1457972283 |
|---|---|
| Provider Enumeration Date | 05/04/2020 |
| Last Update Date | 05/04/2020 |
| Medicare PECOS PAC ID | 1052732740 |
|---|---|
| Medicare Enrollment ID | O20200623000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457972283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Larry L Oteham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700852639 PECOS PAC ID: 8022078153 Enrollment ID: I20110926000725 |
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