| Mountain Medical Associates | |
|
94 Marie Langdon Dr Manchester KY 40962-6353 | |
| (606) 598-5104 | |
| (606) 598-6507 |
| Full Name | Mountain Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 94 Marie Langdon Dr, Manchester, Kentucky |
| Authorized Official Name and Position | Benny Nolen (VICE PRESIDENT) |
| Authorized Official Contact | 6065985104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Medical Associates 509 Memorial Dr Manchester KY 40962-6195 Ph: (606) 598-5104 | Mountain Medical Associates 94 Marie Langdon Dr Manchester KY 40962-6353 Ph: (606) 598-5104 |
| NPI Number | 1447470539 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 01/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447470539 | NPI | - | NPPES |
| 31001134 | Medicaid | KY | |
| CC2941 | Other | KY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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Kishore Internal Medicine, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94 Marie Langdon Dr, Ste 2, Manchester, KY 40962 Phone: 606-599-0200 Fax: 606-599-0202 | |
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