| Kentucky Primary Medical Services Llc | |
|
311 Roy Campbell Dr Hazard KY 41701-9486 | |
| (606) 487-0776 | |
| (606) 487-0777 |
| Full Name | Kentucky Primary Medical Services Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 311 Roy Campbell Dr, Hazard, Kentucky |
| Authorized Official Name and Position | Phillip Randy Mullins (CEO) |
| Authorized Official Contact | 6064870776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Primary Medical Services Llc Po Box 1797 Hazard KY 41702-1797 Ph: (606) 487-0776 | Kentucky Primary Medical Services Llc 311 Roy Campbell Dr Hazard KY 41701-9486 Ph: (606) 487-0776 |
| NPI Number | 1972867224 |
|---|---|
| Provider Enumeration Date | 07/02/2012 |
| Last Update Date | 02/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972867224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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