| |
1010 Medical Center Drive Powderly KY 42367 | |
(270) 377-1600 | |
(270) 388-0229 |
Full Name | |
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Speciality | General Practice |
Location | 1010 Medical Center Drive, Powderly, Kentucky |
Authorized Official Name and Position | Thomas Randall Powell (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2703771650 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1010 Medical Center Drive Powderly KY 42367 Ph: (270) 377-1600 | 1010 Medical Center Drive Powderly KY 42367 Ph: (270) 377-1600 |
NPI Number | 1023019130 |
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Provider Enumeration Date | 08/10/2005 |
Last Update Date | 12/18/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023019130 | NPI | - | NPPES |
35002054 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Baptist Health Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Medical Center Dr, Powderly, KY 42367 Phone: 270-377-1600 Fax: 370-338-0229 | |