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350 Park St Ste 203 Bowling Green KY 42101-1784 | |
| (270) 901-0629 | |
| (270) 901-0892 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 350 Park St Ste 203, Bowling Green, Kentucky |
| Authorized Official Name and Position | Michele Lawless (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 2707451500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2697 Bowling Green KY 42102-7697 Ph: (270) 901-0629 | 350 Park St Ste 203 Bowling Green KY 42101-1784 Ph: (270) 901-0629 |
| NPI Number | 1992180772 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 12/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992180772 | NPI | - | NPPES |
| 7100367470 | Medicaid | KY | |
| 7100456910 | Medicaid | KY |
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