Optimal Health Clinical Llc | |
2415 Ring Rd Ste 100 Elizabethtown KY 42701-7941 | |
(270) 765-2157 | |
Not Available |
Full Name | Optimal Health Clinical Llc |
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Speciality | Family Medicine |
Location | 2415 Ring Rd Ste 100, Elizabethtown, Kentucky |
Authorized Official Name and Position | Kent Williams (DIRECTOR) |
Authorized Official Contact | 2707652157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Optimal Health Clinical Llc 2415 Ring Rd Ste 100 Elizabethtown KY 42701-7941 Ph: (270) 765-2157 | Optimal Health Clinical Llc 2415 Ring Rd Ste 100 Elizabethtown KY 42701-7941 Ph: (270) 765-2157 |
NPI Number | 1952088254 |
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Provider Enumeration Date | 06/29/2023 |
Last Update Date | 06/29/2023 |
Medicare PECOS PAC ID | 9032563424 |
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Medicare Enrollment ID | O20231004001597 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952088254 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Patricia K Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285672451 PECOS PAC ID: 7618862129 Enrollment ID: I20040216000246 |
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