Milum Wound Care Psc | |
3114 Setting Sun Ct Crestwood KY 40014-8409 | |
(502) 930-2874 | |
(502) 339-5700 |
Full Name | Milum Wound Care Psc |
---|---|
Speciality | Family Medicine |
Location | 3114 Setting Sun Ct, Crestwood, Kentucky |
Authorized Official Name and Position | Joseph A Milum (MD/OWNER) |
Authorized Official Contact | 5029302874 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Milum Wound Care Psc 3114 Setting Sun Ct Crestwood KY 40014-8409 Ph: (502) 930-2874 | Milum Wound Care Psc 3114 Setting Sun Ct Crestwood KY 40014-8409 Ph: (502) 930-2874 |
NPI Number | 1306103205 |
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Provider Enumeration Date | 04/16/2012 |
Last Update Date | 04/16/2012 |
Medicare PECOS PAC ID | 2668635749 |
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Medicare Enrollment ID | O20120530000308 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306103205 | NPI | - | NPPES |
64304090 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 30409 (Kentucky) | Primary |
Provider Name | Joseph A Milum |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497759138 PECOS PAC ID: 0042225732 Enrollment ID: I20060216000412 |
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