Kentucky River Medical Partners | |
58 Citation Lane Campbellsburg KY 40011-1426 | |
(502) 532-7341 | |
(502) 532-0127 |
Full Name | Kentucky River Medical Partners |
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Speciality | Family Medicine |
Location | 58 Citation Lane, Campbellsburg, Kentucky |
Authorized Official Name and Position | Damon L Gatewood (OWNER) |
Authorized Official Contact | 5025327341 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kentucky River Medical Partners 58 Citation Lane Campbellsburg KY 40011-1426 Ph: (502) 532-7341 | Kentucky River Medical Partners 58 Citation Lane Campbellsburg KY 40011-1426 Ph: (502) 532-7341 |
NPI Number | 1962574897 |
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Provider Enumeration Date | 11/15/2006 |
Last Update Date | 06/05/2014 |
Medicare PECOS PAC ID | 7719886001 |
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Medicare Enrollment ID | O20040106000380 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962574897 | NPI | - | NPPES |
50003253 | Other | KY | PASSPORT HEALTH PLAN |
7100282440 | Medicaid | KY | |
7100268000 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 37028 (Kentucky) | Primary |
363LF0000X | Nurse Practitioner - Family | 3007904 (Kentucky) | Secondary |
Provider Name | Damon L Gatewood |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912974171 PECOS PAC ID: 6709785090 Enrollment ID: I20091228000068 |
Provider Name | Lori P Abney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053654509 PECOS PAC ID: 5092941054 Enrollment ID: I20131121000414 |