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16701 Ponderosa Dr Catlettsburg KY 41129-9046 | |
(606) 408-8920 | |
(606) 408-8908 |
Full Name | |
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Speciality | Family Medicine |
Location | 16701 Ponderosa Dr, Catlettsburg, Kentucky |
Authorized Official Name and Position | Kristie M Whitlatch (CEO/PRESIDENT) |
Authorized Official Contact | 6064084401 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1595 Ashland KY 41105-1595 Ph: (606) 408-6200 | 16701 Ponderosa Dr Catlettsburg KY 41129-9046 Ph: (606) 408-8920 |
NPI Number | 1922559392 |
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Provider Enumeration Date | 10/20/2016 |
Last Update Date | 10/20/2016 |
Identifier | Type | State | Issuer |
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1922559392 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Kentucky) | Primary |
363A00000X | Physician Assistant | (Kentucky) | Secondary |
363L00000X | Nurse Practitioner | (Kentucky) | Secondary |